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Background: Shunt revisions constitute a major neurosurgical hurdle. The subject has been thoroughly investigated, and recently the term preventable shunt revision rate has been introduced focusing on early malfunctions. We aim to investigate the differences between early and late malfunctions and identify further preventable causes of revision. Methods: The study was based on two databases of shunt surgery from Copenhagen University Hospital and Aarhus University Hospital. We extracted details on shunt surgery, including cause of revision and time to revision. In this study, we presented a Kaplan-Meier curve and made a subdivision in early and late revisions. Causes for early and late revisions were subsequently compared. Results: A total of 622 patients with mean follow-up time of 1.58 years were included. During follow-up 243 (39.1%) patients had at least one shunt revision. The Kaplan-Meier shunt survival curve could be mathematically described as biphasic with an early and a late curve section. The intersection between the two sections was at 0.2 years. Shunt survival was 77.7% at 0.2 years and 59.5% at two years. The causes for early and late revisions differed significantly in terms of infections (early revision), valve defects, and disconnections (late revisions). Conclusions: We found that early shunt revisions are predominant, and that causes for early shunt revisions in some terms differ from late shunt revisions. In early revisions infections are overrepresented, while valve defects and disconnections are overrepresented in late revisions. Our findings suggest that reduction of early and late shunt revisions could require different strategies.

Background: Shunt revisions constitute a major neurosurgical hurdle. The subject has been thoroughly investigated, and recently the term preventable shunt revision rate has been introduced focusing on early malfunctions. We aim to investigate the differences between early and late malfunctions and identify further preventable causes of revision. Methods: The study was based on two databases of shunt surgery from Copenhagen University Hospital and Aarhus University Hospital. We extracted details on shunt surgery, including cause of revision and time to revision. In this study, we presented a Kaplan-Meier curve and made a subdivision in early and late revisions. Causes for early and late revisions were subsequently compared. Results: A total of 622 patients with mean follow-up time of 1.58 years were included. During follow-up 243 (39.1%) patients had at least one shunt revision. The Kaplan-Meier shunt survival curve could be mathematically described as biphasic with an early and a late curve section. The intersection between the two sections was at 0.2 years. Shunt survival was 77.7% at 0.2 years and 59.5% at two years. The causes for early and late revisions differed significantly in terms of infections (early revision), valve defects, and disconnections (late revisions). Conclusions: We found that early shunt revisions are predominant, and that causes for early shunt revisions in some terms differ from late shunt revisions. In early revisions infections are overrepresented, while valve defects and disconnections are overrepresented in late revisions. Our findings suggest that reduction of early and late shunt revisions could require different strategies.

This dissertation describes the development of a self-contained high-frequency high sensitivity implantable microfluidics flow sensor using MTJ magnetic sensors to detect motion of slow-moving fluids. A motivating application for the proposed device is the development of an implantable flow sensor, capable of monitoring the amount of cerebral spinal fluid drained from the ventricles of the brain. Micro-fabricated ferromagnetic flaps are used to detect motion of the surrounding fluid. The deflection of the flaps is detected by an ultra-sensitive MTJ magnetic field sensor placed outside of the lumen of the catheter. Numerical and experimental results are provided demonstrating a resolution of 0.4 ml/h, a working range of 0-40 ml/h, and a maximum uncertainty of 4% RMS. The present study identifies thermal noise as the main source of low-frequency drift. Using thermal compensation, it was found that the drift can be reduced below 2 ml per 24-hr. Combining an array of four transducers operating in series, it has been demonstrated that a sensitivity can be increased 10.9-fold. Furthermore, the report examines the long-term structural stability of the sensors and produces a corrosion report suggesting a lifespan of 15 to 55 years. MRI compatibility analysis showed a sensitivity reduction of 64% in the device. Several in vivo recalibration methods were introduced to eliminate the calibration error. A protein deposition study showed stable sensor performance under 1.5 mg/ml protein concentration.

Small bowel perforation is a rare complication of ventriculoperitoneal (VP) shunt placement. When seen, it most commonly affects the stomach or colon. We describe a case and image findings of an 8-year-old female who presented with sepsis and erosion of the VP shunt into the small bowel. The imaging findings were confirmed surgically. We also provide an overview of the current literature discussing previously reported cases, clinical features, and treatment.

Background: The use of ventriculoperitoneal (VP) shunts has become ubiquitous in neurosurgery for the treatment of hydrocephalus. VP shunts work by creating a conduit for cerebrospinal fluid (CSF) to flow from the cerebral ventricles to the peritoneum and thus relieving pressure. Although typically safe, VP shunt complications are extremely common, occurring in up to 29% of adult cases and approximately half of pediatric cases. These complications may require patients to undergo several revisions throughout their lifetimePurpose: We describe a man who developed scalp necrosis overlying his VP shunt. We also summarize the potential complications of VP shunts. We discuss the presentation and pathogenesis of scalp necrosis in these patients.Materials and methods: A PubMed search of the following terms was performed and relevant citations were assessed: ventriculoperitoneal shunt, VP shunt, shunt complications, scalp necrosis, skin necrosis, ventriculoperitoneal shunt induced scalp necrosis, ventriculoperitoneal shunt induced skin necrosis.Results: A 73-year-old man developed VP shunt-induced scalp necrosis leading to loss of skin overlying the shunt valve. The patient was emergently referred to neurosurgery and admitted for revision of the shunt due to the significant risk for infection. The VP shunt was replaced with an external drain and a skin flap was used to repair the defect.Conclusion: VP shunts are devices that are frequently used for reducing intracranial pressure associated with hydrocephalus. The insertion of the shunt beneath the scalp sets the stage for potential pressure-induced scalp necrosis. The early recognition and diagnosis of VP shunt-induced scalp necrosis is essential to prevent infections and future complications.

Background: The use of ventriculoperitoneal (VP) shunts has become ubiquitous in neurosurgery for the treatment of hydrocephalus. VP shunts work by creating a conduit for cerebrospinal fluid (CSF) to flow from the cerebral ventricles to the peritoneum and thus relieving pressure. Although typically safe, VP shunt complications are extremely common, occurring in up to 29% of adult cases and approximately half of pediatric cases. These complications may require patients to undergo several revisions throughout their lifetimePurpose: We describe a man who developed scalp necrosis overlying his VP shunt. We also summarize the potential complications of VP shunts. We discuss the presentation and pathogenesis of scalp necrosis in these patients.Materials and methods: A PubMed search of the following terms was performed and relevant citations were assessed: ventriculoperitoneal shunt, VP shunt, shunt complications, scalp necrosis, skin necrosis, ventriculoperitoneal shunt induced scalp necrosis, ventriculoperitoneal shunt induced skin necrosis.Results: A 73-year-old man developed VP shunt-induced scalp necrosis leading to loss of skin overlying the shunt valve. The patient was emergently referred to neurosurgery and admitted for revision of the shunt due to the significant risk for infection. The VP shunt was replaced with an external drain and a skin flap was used to repair the defect.Conclusion: VP shunts are devices that are frequently used for reducing intracranial pressure associated with hydrocephalus. The insertion of the shunt beneath the scalp sets the stage for potential pressure-induced scalp necrosis. The early recognition and diagnosis of VP shunt-induced scalp necrosis is essential to prevent infections and future complications.

Hydrocephalus is a common clinical problem found in pediatric neurosurgical practice. This condition involves dilatation of cerebral ventricular system due to various etiologies. It is classified into two conditions, communicative and obstruction type. Various etiologies cause different clinical features and need different modality of treatments. Ventriculoperitoneal shunt is the gold standard of treatment, but Endoscopic 3rd ventriculostomy is considered as a treatment of choice nowadays. This article concerns all aspect of this condition: epidemiology, etiology, pathophysiology, simptoms and clinical findings, treatment, and prognosis.

Kytococcus schroeteri is a newly described micrococcal species and, to date, has been associated mostly with endocarditis. Six infections attributable to this opportunistic pathogen have been described since 2002, when the first case was identified. We describe here the first pediatric case of a K. schroeteri ventriculoperitoneal shunt infection. The child was successfully treated with a combination of rifampin and vancomycin and shunt replacement. Initially identified as a Micrococcus spp. by both automated identification and conventional biochemical testing, sequencing of the 16S ribosomal RNA gene enabled accurate identification of the organism., Case Reports, Journal Article, info:eu-repo/semantics/published

Kytococcus schroeteri is a newly described micrococcal species and, to date, has been associated mostly with endocarditis. Six infections attributable to this opportunistic pathogen have been described since 2002, when the first case was identified. We describe here the first pediatric case of a K. schroeteri ventriculoperitoneal shunt infection. The child was successfully treated with a combination of rifampin and vancomycin and shunt replacement. Initially identified as a Micrococcus spp. by both automated identification and conventional biochemical testing, sequencing of the 16S ribosomal RNA gene enabled accurate identification of the organism., Case Reports, Journal Article, info:eu-repo/semantics/published