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DOI: 10.1055/s-0043-1775729
Bifrontal–Parietal Ratio: A Novel Risk Factor for Cerebrospinal Fluid Overdrainage after Ventriculoperitoneal Shunting
Funding None.![](https://www.thieme-connect.de/media/10.1055-s-00053244/202401/lookinside/thumbnails/10-1055-s-0043-1775729_2310001-1.jpg)
Abstract
Objective This study aimed to examine potential risk factors associated with cerebrospinal fluid overdrainage after ventriculoperitoneal (VP) shunting.
Materials and Methods We retrospectively examined the medical records of hydrocephalus patients who underwent VP shunting at a single institution between January 2011 and December 2017 and had a minimum 3-year follow-up. Variables studied included age, gender, hydrocephalus etiology, symptoms, shunt valve, ventricular catheter entry point, and neurosurgical history, including history of external ventricular drainage. Radiographic variables included Evans index, bicaudate index, callosal angle, measurements of frontal lobe thickness, and bifrontal–parietal ratio.
Results Among the 182 study patients, 11 experienced overdrainage. Age, gender, etiology, symptoms, and surgical history did not significantly differ between patients who experienced overdrainage and those who did not. Evans index, bicaudate index, and callosal angle did not significantly differ between the groups. Measurements of frontal lobe thickness and bifrontal–-parietal ratio were significantly lower in the overdrainage group.
Conclusion Bifrontal–parietal ratio may be useful to predict overdrainage after VP shunt surgery.
Ethical Approval
This study was approved by the Human Research Ethics Committee, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
Publication History
Article published online:
07 November 2023
© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Stone JJ, Walker CT, Jacobson M, Phillips V, Silberstein HJ. Revision rate of pediatric ventriculoperitoneal shunts after 15 years. J Neurosurg Pediatr 2013; 11 (01) 15-19
- 2 Aldrich EF, Harmann P. Disconnection as a cause of ventriculoperitoneal shunt malfunction in multicomponent shunt systems. Pediatr Neurosurg 1990; -1991 16 (06) 309-311 , discussion 312
- 3 Braga MH, Carvalho GT, Brandão RA, Lima FB, Costa BS. Early shunt complications in 46 children with hydrocephalus. Arq Neuropsiquiatr 2009; 67 (2A): 273-277
- 4 Choudhury AR. Avoidable factors that contribute to the complications of ventriculoperitoneal shunt in childhood hydrocephalus. Childs Nerv Syst 1990; 6 (06) 346-349
- 5 Elisevich K, Mattar AG, Cheeseman F. Biodegradation of distal shunt catheters. Pediatr Neurosurg 1994; 21 (01) 71-76
- 6 Keucher TR, Mealey Jr J. Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 1979; 50 (02) 179-186
- 7 Sun T, Yuan Y, Zhang Q. et al. One-year outcome of patients with posttraumatic hydrocephalus treated by lumboperitoneal shunt: an observational study from China. Acta Neurochir (Wien) 2018; 160 (10) 2031-2038
- 8 Khan QU, Wharen RE, Grewal SS. et al. Overdrainage shunt complications in idiopathic normal-pressure hydrocephalus and lumbar puncture opening pressure. J Neurosurg 2013; 119 (06) 1498-1502
- 9 Hung CW, Lin WC, Chang WN. et al. Risk factors and outcomes of cerebrospinal fluid overdrainage in HIV-negative patients with cryptococcal meningitis after the ventriculoperitoneal shunting procedure. J Microbiol Immunol Infect 2018; 51 (04) 545-551
- 10 Weprin BE, Swift DM. Complications of ventricular shunts. Tech in Neurosurg 2001; 7 (03) 224-242
- 11 Pudenz RH, Foltz EL. Hydrocephalus: overdrainage by ventricular shunts. A review and recommendations. Surg Neurol 1991; 35 (03) 200-212
- 12 Kondageski C, Thompson D, Reynolds M, Hayward RD. Experience with the Strata valve in the management of shunt overdrainage. J Neurosurg 2007; 106 (2, Suppl): 95-102
- 13 Ringel F, Schramm J, Meyer B. Comparison of programmable shunt valves vs standard valves for communicating hydrocephalus of adults: a retrospective analysis of 407 patients. Surg Neurol 2005; 63 (01) 36-41 , discussion 41
- 14 Ross DA, Olsen WL, Ross AM, Andrews BT, Pitts LH. Brain shift, level of consciousness, and restoration of consciousness in patients with acute intracranial hematoma. J Neurosurg 1989; 71 (04) 498-502
- 15 Foelholm R, Waltimo O. Epidemiology of chronic subdural haematoma. Acta Neurochir (Wien) 1975; 32 (3-4): 247-250
- 16 Bermel RA, Bakshi R, Tjoa C, Puli SR, Jacobs L. Bicaudate ratio as a magnetic resonance imaging marker of brain atrophy in multiple sclerosis. Arch Neurol 2002; 59 (02) 275-280
- 17 Brickman AM, Honig LS, Scarmeas N. et al. Measuring cerebral atrophy and white matter hyperintensity burden to predict the rate of cognitive decline in Alzheimer disease. Arch Neurol 2008; 65 (09) 1202-1208