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Shunt revision

There is elevated risk of shunt infection associated with shunt revisions observed in clinical practice. To reduce risk of infection risk, further work should optimize revision procedures 1).

see Preventable Shunt Revision Rate.

The decision to admit a shunt-treated patient from the emergency department for symptoms related to idiopathic intracranial hypertension (IIH) is challenging. Knowledge of factors associated with the need for admission and/or shunt revision is required. In a study, factors such as male sex, younger age at presentation, lower number of prior emergency department visits, and performance of a diagnostic LP were independent predictors of admission. In addition, papilledema was strongly predictive of the need for shunt revision, highlighting the importance of an ophthalmological examination for shunt-treated adults with IIH who present to the emergency department 2).

Simon TD, Butler J, Whitlock KB, Browd SR, Holubkov R, Kestle JR, Kulkarni AV, Langley M, Limbrick DD Jr, Mayer-Hamblett N, Tamber M, Wellons JC 3rd, Whitehead WE, Riva-Cambrin J; Hydrocephalus Clinical Research Network. Risk Factors for First Cerebrospinal Fluid Shunt Infection: Findings from a Multi-Center Prospective Cohort Study. J Pediatr. 2014 Mar 21. pii: S0022-3476(14)00114-0. doi: 10.1016/j.jpeds.2014.02.013. [Epub ahead of print] PubMed PMID: 24661340.
Sankey EW, Elder BD, Liu A, Carson KA, Goodwin CR, Jusué-Torres I, Rigamonti D. Predictors of admission and shunt revision during emergency department visits for shunt-treated adult patients with idiopathic intracranial hypertension. J Neurosurg. 2017 Aug;127(2):233-239. doi: 10.3171/2016.5.JNS151303. Epub 2016 Sep 23. PubMed PMID: 27662535.
shunt_revision.txt · Last modified: 2017/08/07 13:01 by administrador