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Bilateral abducens and facial nerve palsies following fourth ventriculoperitoneal shunt with laparoscopic-assisted abdominal catheter placement.
Herrada-Pineda, Tenoch; Manrique-Guzman, Salvador; Perez-Vazquez, Ana Karen; Revilla-Pacheco, Francisco R; Guzman-Navarro, Leopoldo; Garmilla-Espinosa, Jose; Hernandez-Valencia, Jose Arturo; Sanchez-Zacarias, Tania Ivette; Wilches-Davalos, Maria Jose.
Afiliación
  • Herrada-Pineda T; ABC Medical Center. Neurosurgery Department, Mexico City, Mexico.
  • Manrique-Guzman S; Neurosurgery Department. Angeles Lomas Hospital, State of Mexico, Mexico.
  • Perez-Vazquez AK; ABC Medical Center. Neurosurgery Department, Mexico City, Mexico.
  • Revilla-Pacheco FR; Neurosurgery Department. Angeles Lomas Hospital, State of Mexico, Mexico.
  • Guzman-Navarro L; Center for Health Sciences Research (CICSA), Health Sciences Faculty. Anahuac University, State of Mexico, Mexico.
  • Garmilla-Espinosa J; Neurosurgery Department. Angeles Lomas Hospital, State of Mexico, Mexico.
  • Hernandez-Valencia JA; ABC Medical Center. Neurosurgery Department, Mexico City, Mexico.
  • Sanchez-Zacarias TI; Neurosurgery Department. Angeles Lomas Hospital, State of Mexico, Mexico.
  • Wilches-Davalos MJ; ABC Medical Center. General Surgery Department. Mexico City, Mexico.
Brain Spine ; 4: 102824, 2024.
Article en En | MEDLINE | ID: mdl-38706799
ABSTRACT

Introduction:

Hydrocephalus, altering cerebrospinal fluid (CSF) dynamics, affects 175 per 100,000 adults worldwide. Ventriculoperitoneal shunts (VPS) manage symptomatic hydrocephalus, with 125,000 cases annually. Despite efficacy, VPS face complications, necessitating interventions. Research question "What are the mechanisms and risk factors for bilateral VIth and VIIth lower motor neuron palsies in hydrocephalus patients with a fourth ventriculoperitoneal shunt?" Material and

methods:

This study details a 36-year-old female with a neonatal meningitis history, multiple shunt replacements, admitted for abdominal pain secondary to pelvic inflammatory disease. An abdominal shunt catheter removal and external ventricular drain placement occurred after consultation with a general surgeon. A cardiac atrial approach and subsequent laparoscopic abdominal approach were performed without complications.

Results:

After one month, the patient showed neurological complications, including decreased facial expression, gait instability, and bilateral VIth and VIIth lower motor neuron palsies, specifically upgazed and convergence restriction.

Discussion:

The complication's pathophysiology is discussed, attributing it to potential brainstem herniation from over-drainage of CSF. Literature suggests flexible endoscopic treatments like aqueductoplasty/transaqueductal approaches into the fourth ventricle.

Conclusions:

This study underscores the need for increased awareness in monitoring neurological outcomes after the fourth ventriculoperitoneal shunt, particularly in cases with laparoscopic-assisted abdominal catheter placement. The rarity of bilateral abducens and facial nerve palsies emphasizes the importance of ongoing research to understand pathophysiology and develop preventive and therapeutic strategies for this unique complication.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Brain Spine Año: 2024 Tipo del documento: Article País de afiliación: México Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Brain Spine Año: 2024 Tipo del documento: Article País de afiliación: México Pais de publicación: Países Bajos