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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Children with post intraventricular haemorrhage hydrocephalus need a higher shunt valve pressure than children with other hydrocephalus aetiologies – a prospective monocentric study

Kinder mit Hydrozephalus nach intraventrikulärer Blutung benötigen eine höhere Ventildruckstufe gegenüber Kindern mit Hydrozephalus anderer Ursache – eine prospektive monozentrische Studie

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  • presenting/speaker Adriano Cattani - Universitätsklinikum, Goethe-University, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Franziska Schwarzer - Universitätsklinikum, Goethe-University, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Andrea Spyrantis - Universitätsklinikum, Goethe-University, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Gerhard Marquardt - Universitätsklinikum, Goethe-University, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Susanne Schubert-Bast - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
  • Volker Seifert - Universitätsklinikum, Goethe-University, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Thomas Freiman - Universitätsklinikum, Goethe-University, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV167

doi: 10.3205/19dgnc194, urn:nbn:de:0183-19dgnc1943

Published: May 8, 2019

© 2019 Cattani et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: In the last few years, the number of ventriculoperitoneal shunt (VP-Shunt) with adjustable valve pressure implantations increased in several neurosurgical departments around the world. However, the right valve pressure set up in order to avoid VP-Shunt complications as underdrainage or overdrainage still not clear in the literature. To address this question we performed a prospective study from hydrocephalic children implanted with adjustable VP-Shunt performing valve pressure changes according to their head circumferences (HC) and transfontanelle ultrasonographic (TU) measurements.

Methods: Fortythree hydrocephalic children were prospectively included in a 4 years period between 2014 and 2018. All children were implanted with an adjustable valve pressure VP-Shunt system (proGAV) with initially valve pressure set at 5 H2O. Head circumferences and TU ventricular size measurements were performed with follow-up amounted between 10 days and 2 month. Valve pressure lower adjustments were done when HC exceeded the 90th percentile and higher adjustments when HC was lower than the 10th percentile. The patients were divided into two groups: post intraventricular haemorrhage hydrocephalus (pIVHH), and mature children with congenital or acquired hydrocephalus (non intraventricular haemorrhage hydrocephalus; nIVHH) and analysed separately. For statistical analysis, ANOVA has been used and p values <0.05 were considered as statistically significant.

Results: The pIVHH group (n=20) needed more valve pressure modifications than the nIVHH group (n=23) to achieve HC stabilization (Mean 3.7±1.42 CI95 versus 2.95±1.41 CI95, respectively). Finally the last valve pressure mean value was 8.1 cm H2O (±1.62 CI95) in the pIVHH group versus 5.56 cm H2O (±1.29 CI95) in the nIVHH (p=0.013).

Conclusion: The results in this study show that children with hydrocephalus due to intraventricular haemorrhage need more VP-Shunt valve pressure modifications to achieve HC stabilization and require higher VP-Shunt valve pressure values at long-term follow up comparing to children with other hydrocephalus aetiologies.