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Ito R, Fuse Y, Ito K, Hatano H, Saito R. Neonatal Ventricular Reservoir Implantation for Hydrocephalus Management in Chiari III Malformations: A Case Report. Cureus 2024; 16:e55896. [PMID: 38595901 PMCID: PMC11003560 DOI: 10.7759/cureus.55896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Chiari III malformation, a rare and severe subtype of Chiari malformations, is frequently associated with hydrocephalus. The conventional treatment approaches for hydrocephalus in Chiari III malformations have mainly focused on ventriculoperitoneal (VP) shunting, but optimal methods and timing remain uncertain. We report a case of a newborn girl with Chiari III malformation who underwent surgical closure of an occipitocervical encephalocele and ventricular reservoir implantation on her third day of life. This procedure successfully managed her hydrocephalus without significant short-term complications. Three months post-surgery, she developed secondary external hydrocephalus, which was managed through subdural-peritoneal shunting, allowing her to thrive until at least five years of age. This case demonstrates the potential of ventricular reservoir implantation in treating hydrocephalus associated with Chiari III malformation and brings to light secondary external hydrocephalus, subsequently managed by VP shunting.
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Affiliation(s)
- Risa Ito
- Department of Neurosurgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, JPN
| | - Yutaro Fuse
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, JPN
- Academia-Industry Collaboration Platform for Cultivating Medical AI Leaders, Nagoya University, Nagoya, JPN
| | - Keishi Ito
- Department of Neurosurgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, JPN
| | - Hisashi Hatano
- Department of Neurosurgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, JPN
| | - Ryuta Saito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, JPN
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Zhu T, Fu J, Zang D, Wang Z, Ye X, Wu X, Hu J. Combination of Conventional EVD and Ommaya Drainage for Intraventricular Hemorrhage (IVH). Clin Interv Aging 2024; 19:1-10. [PMID: 38192377 PMCID: PMC10771781 DOI: 10.2147/cia.s436522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/17/2023] [Indexed: 01/10/2024] Open
Abstract
Background The effect of Ommaya reservoirs on the clinical outcomes of patients with intraventricular hemorrhage (IVH) remains unclear. Objective We aimed to determine the effect of combining the Ommaya reservoir and external ventricular drainage (EVD) therapy on IVH and explore better clinical indicators for Ommaya implantation. Methods A retrospective analysis was conducted on patients diagnosed with IVH who received EVD-Ommaya drainage between January 2013 and March 2021. The patient population was divided into two groups: the Ommaya-used group, comprising patients in whom the Ommaya drainage system was activated post-surgery, and the Ommaya-unused group, comprising patients in whom the system was not activated. The study analyzed clinical, imaging, and outcome data of the patient population. Results A total of 123 patients with IVH were included: 75 patients in the Ommaya-used group and 48 patients in the Ommaya-unused group. The patients in the Ommaya-used group showed a lower 3-month GOS than those in the Ommaya-unused group (p<0.0001). The modified Graeb scale (mGS) in the Ommaya-unused group was significantly lower than that in the Ommaya-used group before the operation (p<0.01) but not after surgery (p>0.05). The GCS in the Ommaya-unused group was significantly lower than that in the other group, and there was a close correlation between the GCS and 3-month GOS (p<0.0001). The GCS score showed significance in predicting the use of Ommaya (p<0.001). Conclusion The study demonstrated that combining EVD and Ommaya drainage was a safe and feasible treatment for IVH. Additionally, preoperative GCS was found to predict the use of Ommaya drainage in subsequent treatment, providing valuable information for pre-surgery decision-making.
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Affiliation(s)
- Tongming Zhu
- Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China
| | - Junyan Fu
- Department of Radiology, Fudan University Huashan Hospital, Shanghai, People’s Republic of China
| | - Di Zang
- Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China
- Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, People’s Republic of China
| | - Zhe Wang
- Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China
- Department of Medical Imaging Technology, SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Shanghai, People’s Republic of China
| | - Xiangru Ye
- Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China
| | - Xuehai Wu
- Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China
| | - Jin Hu
- Department of Neurosurgery, Fudan University Huashan Hospital, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Shanghai Key Laboratory of Brain Function and Regeneration, Institutes of Brain Science, MOE Frontiers Center for Brain Science, Shanghai Medical College-Fudan University, Shanghai, People’s Republic of China
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