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Programmable valve breakage in shunt systems of children with posthemorrhagic hydrocephalus after minor head trauma—a case series
Purpose We report five rare cases of programmable valve breakage (Codman Hakim-Medos valve) in shunt systems of children with posthemorrhagic hydrocephalus. Only four similar studies have been published in the current literature. Methods Between 2013 and 2018, five children with posthemorrhagic hydr...
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Published in: | Child's nervous system 2020-09, Vol.36 (9), p.2027-2031 |
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container_title | Child's nervous system |
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creator | Schwarm, Frank P. Nagl, Jasmin Bender, Michael Stein, Marco Giese, Kerstin Hahn, Andreas Uhl, Eberhard Kolodziej, Malgorzata A. |
description | Purpose
We report five rare cases of programmable valve breakage (Codman Hakim-Medos valve) in shunt systems of children with posthemorrhagic hydrocephalus. Only four similar studies have been published in the current literature.
Methods
Between 2013 and 2018, five children with posthemorrhagic hydrocephalus were admitted to the pediatric department. All patients had a history of slight blows to the head in a minor trauma and follow up MRI scans. After initial clinical examination, cranial computed tomography (CT) and X-ray were conducted.
Results
In all cases, pumping the reservoir resulted in very slow refilling. The cranial CT in one patient showed slit ventricles confirming the suspicion of overdrainage, the other cases a slight enhancement of the hydrocephalus. In lateral X-rays of the skull in comparison to the first X-ray control of the shunt valve, the pressure control chamber could be seen dislocated in the inferior part of the reservoir in all cases. Surgery revealed that the shunt valve was broken. The pressure control chamber had dropped to the bottom of the reservoir. After implantation of a new shunt valve, the symptoms resolved completely in all five children. Overall this complication occurred in 4.3% (5 of 85 implanted Codman Hakim-Medos valve) of all children necessitating ventriculoperitoneal shunt implantation between January 2013 and December 2018.
Conclusion
The well-accepted Codman Hakim-Medos programmable valve is part of a tube-system, which is designed to offer the possibility of a reliable and precise treatment of hydrocephalus. Various mechanical and non-mechanical complications of shunt systems have been reported. Valve breakage is a very rare condition, often missed, and must be kept in mind when trauma and prior MRI scan are reported. |
doi_str_mv | 10.1007/s00381-020-04541-6 |
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We report five rare cases of programmable valve breakage (Codman Hakim-Medos valve) in shunt systems of children with posthemorrhagic hydrocephalus. Only four similar studies have been published in the current literature.
Methods
Between 2013 and 2018, five children with posthemorrhagic hydrocephalus were admitted to the pediatric department. All patients had a history of slight blows to the head in a minor trauma and follow up MRI scans. After initial clinical examination, cranial computed tomography (CT) and X-ray were conducted.
Results
In all cases, pumping the reservoir resulted in very slow refilling. The cranial CT in one patient showed slit ventricles confirming the suspicion of overdrainage, the other cases a slight enhancement of the hydrocephalus. In lateral X-rays of the skull in comparison to the first X-ray control of the shunt valve, the pressure control chamber could be seen dislocated in the inferior part of the reservoir in all cases. Surgery revealed that the shunt valve was broken. The pressure control chamber had dropped to the bottom of the reservoir. After implantation of a new shunt valve, the symptoms resolved completely in all five children. Overall this complication occurred in 4.3% (5 of 85 implanted Codman Hakim-Medos valve) of all children necessitating ventriculoperitoneal shunt implantation between January 2013 and December 2018.
Conclusion
The well-accepted Codman Hakim-Medos programmable valve is part of a tube-system, which is designed to offer the possibility of a reliable and precise treatment of hydrocephalus. Various mechanical and non-mechanical complications of shunt systems have been reported. Valve breakage is a very rare condition, often missed, and must be kept in mind when trauma and prior MRI scan are reported.</description><identifier>ISSN: 0256-7040</identifier><identifier>EISSN: 1433-0350</identifier><identifier>DOI: 10.1007/s00381-020-04541-6</identifier><identifier>PMID: 32078023</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cerebrospinal Fluid Shunts ; Child ; Craniocerebral Trauma ; Humans ; Hydrocephalus - diagnostic imaging ; Hydrocephalus - etiology ; Hydrocephalus - surgery ; Medicine ; Medicine & Public Health ; Neurosciences ; Neurosurgery ; Original Article ; Reoperation ; Ventriculoperitoneal Shunt</subject><ispartof>Child's nervous system, 2020-09, Vol.36 (9), p.2027-2031</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-4df0838e039929b81a6bd67150cf33f64089c423071ca353e1b34b23cebfa6373</citedby><cites>FETCH-LOGICAL-c347t-4df0838e039929b81a6bd67150cf33f64089c423071ca353e1b34b23cebfa6373</cites><orcidid>0000-0001-5030-1870</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32078023$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schwarm, Frank P.</creatorcontrib><creatorcontrib>Nagl, Jasmin</creatorcontrib><creatorcontrib>Bender, Michael</creatorcontrib><creatorcontrib>Stein, Marco</creatorcontrib><creatorcontrib>Giese, Kerstin</creatorcontrib><creatorcontrib>Hahn, Andreas</creatorcontrib><creatorcontrib>Uhl, Eberhard</creatorcontrib><creatorcontrib>Kolodziej, Malgorzata A.</creatorcontrib><title>Programmable valve breakage in shunt systems of children with posthemorrhagic hydrocephalus after minor head trauma—a case series</title><title>Child's nervous system</title><addtitle>Childs Nerv Syst</addtitle><addtitle>Childs Nerv Syst</addtitle><description>Purpose
We report five rare cases of programmable valve breakage (Codman Hakim-Medos valve) in shunt systems of children with posthemorrhagic hydrocephalus. Only four similar studies have been published in the current literature.
Methods
Between 2013 and 2018, five children with posthemorrhagic hydrocephalus were admitted to the pediatric department. All patients had a history of slight blows to the head in a minor trauma and follow up MRI scans. After initial clinical examination, cranial computed tomography (CT) and X-ray were conducted.
Results
In all cases, pumping the reservoir resulted in very slow refilling. The cranial CT in one patient showed slit ventricles confirming the suspicion of overdrainage, the other cases a slight enhancement of the hydrocephalus. In lateral X-rays of the skull in comparison to the first X-ray control of the shunt valve, the pressure control chamber could be seen dislocated in the inferior part of the reservoir in all cases. Surgery revealed that the shunt valve was broken. The pressure control chamber had dropped to the bottom of the reservoir. After implantation of a new shunt valve, the symptoms resolved completely in all five children. Overall this complication occurred in 4.3% (5 of 85 implanted Codman Hakim-Medos valve) of all children necessitating ventriculoperitoneal shunt implantation between January 2013 and December 2018.
Conclusion
The well-accepted Codman Hakim-Medos programmable valve is part of a tube-system, which is designed to offer the possibility of a reliable and precise treatment of hydrocephalus. Various mechanical and non-mechanical complications of shunt systems have been reported. Valve breakage is a very rare condition, often missed, and must be kept in mind when trauma and prior MRI scan are reported.</description><subject>Cerebrospinal Fluid Shunts</subject><subject>Child</subject><subject>Craniocerebral Trauma</subject><subject>Humans</subject><subject>Hydrocephalus - diagnostic imaging</subject><subject>Hydrocephalus - etiology</subject><subject>Hydrocephalus - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Reoperation</subject><subject>Ventriculoperitoneal Shunt</subject><issn>0256-7040</issn><issn>1433-0350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kL1u1UAQhVcIRC6BF6BAW9I4zO6s_0oUEUCKBAXUq_F6fO1gey87dqLbIfEKPCFPguEGSqopzneONJ9Szw1cGIDylQBgZTKwkIHLncmKB2pnHGIGmMNDtQObF1kJDs7UE5EbAJNXtn6sztBCWYHFnfr-McV9ommiZmR9S-Mt6yYxfaE962HW0q_zouUoC0-iY6dDP4xt4lnfDUuvD1GWnqeYUk_7Iej-2KYY-NDTuIqmbuGkp2GOSfdMrV4SrRP9_PaDdCBhLZwGlqfqUUej8LP7e64-X735dPkuu_7w9v3l6-ssoCuXzLUdVFgxYF3buqkMFU1blCaH0CF2hYOqDs4ilCYQ5simQddYDNx0VGCJ5-rlafeQ4teVZfHTIIHHkWaOq3iLee0wz0vcUHtCQ4oiiTt_SMNE6egN-N_y_Um-3-T7P_J9sZVe3O-vzcTtv8pf2xuAJ0C2aN5z8jdxTfP28_9mfwHVyJKb</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Schwarm, Frank P.</creator><creator>Nagl, Jasmin</creator><creator>Bender, Michael</creator><creator>Stein, Marco</creator><creator>Giese, Kerstin</creator><creator>Hahn, Andreas</creator><creator>Uhl, Eberhard</creator><creator>Kolodziej, Malgorzata A.</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5030-1870</orcidid></search><sort><creationdate>20200901</creationdate><title>Programmable valve breakage in shunt systems of children with posthemorrhagic hydrocephalus after minor head trauma—a case series</title><author>Schwarm, Frank P. ; Nagl, Jasmin ; Bender, Michael ; Stein, Marco ; Giese, Kerstin ; Hahn, Andreas ; Uhl, Eberhard ; Kolodziej, Malgorzata A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-4df0838e039929b81a6bd67150cf33f64089c423071ca353e1b34b23cebfa6373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cerebrospinal Fluid Shunts</topic><topic>Child</topic><topic>Craniocerebral Trauma</topic><topic>Humans</topic><topic>Hydrocephalus - diagnostic imaging</topic><topic>Hydrocephalus - etiology</topic><topic>Hydrocephalus - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Reoperation</topic><topic>Ventriculoperitoneal Shunt</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schwarm, Frank P.</creatorcontrib><creatorcontrib>Nagl, Jasmin</creatorcontrib><creatorcontrib>Bender, Michael</creatorcontrib><creatorcontrib>Stein, Marco</creatorcontrib><creatorcontrib>Giese, Kerstin</creatorcontrib><creatorcontrib>Hahn, Andreas</creatorcontrib><creatorcontrib>Uhl, Eberhard</creatorcontrib><creatorcontrib>Kolodziej, Malgorzata A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Child's nervous system</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schwarm, Frank P.</au><au>Nagl, Jasmin</au><au>Bender, Michael</au><au>Stein, Marco</au><au>Giese, Kerstin</au><au>Hahn, Andreas</au><au>Uhl, Eberhard</au><au>Kolodziej, Malgorzata A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Programmable valve breakage in shunt systems of children with posthemorrhagic hydrocephalus after minor head trauma—a case series</atitle><jtitle>Child's nervous system</jtitle><stitle>Childs Nerv Syst</stitle><addtitle>Childs Nerv Syst</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>36</volume><issue>9</issue><spage>2027</spage><epage>2031</epage><pages>2027-2031</pages><issn>0256-7040</issn><eissn>1433-0350</eissn><abstract>Purpose
We report five rare cases of programmable valve breakage (Codman Hakim-Medos valve) in shunt systems of children with posthemorrhagic hydrocephalus. Only four similar studies have been published in the current literature.
Methods
Between 2013 and 2018, five children with posthemorrhagic hydrocephalus were admitted to the pediatric department. All patients had a history of slight blows to the head in a minor trauma and follow up MRI scans. After initial clinical examination, cranial computed tomography (CT) and X-ray were conducted.
Results
In all cases, pumping the reservoir resulted in very slow refilling. The cranial CT in one patient showed slit ventricles confirming the suspicion of overdrainage, the other cases a slight enhancement of the hydrocephalus. In lateral X-rays of the skull in comparison to the first X-ray control of the shunt valve, the pressure control chamber could be seen dislocated in the inferior part of the reservoir in all cases. Surgery revealed that the shunt valve was broken. The pressure control chamber had dropped to the bottom of the reservoir. After implantation of a new shunt valve, the symptoms resolved completely in all five children. Overall this complication occurred in 4.3% (5 of 85 implanted Codman Hakim-Medos valve) of all children necessitating ventriculoperitoneal shunt implantation between January 2013 and December 2018.
Conclusion
The well-accepted Codman Hakim-Medos programmable valve is part of a tube-system, which is designed to offer the possibility of a reliable and precise treatment of hydrocephalus. Various mechanical and non-mechanical complications of shunt systems have been reported. Valve breakage is a very rare condition, often missed, and must be kept in mind when trauma and prior MRI scan are reported.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32078023</pmid><doi>10.1007/s00381-020-04541-6</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-5030-1870</orcidid></addata></record> |
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subjects | Cerebrospinal Fluid Shunts Child Craniocerebral Trauma Humans Hydrocephalus - diagnostic imaging Hydrocephalus - etiology Hydrocephalus - surgery Medicine Medicine & Public Health Neurosciences Neurosurgery Original Article Reoperation Ventriculoperitoneal Shunt |
title | Programmable valve breakage in shunt systems of children with posthemorrhagic hydrocephalus after minor head trauma—a case series |
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