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Acta Neurochirurgica

, Volume 155, Issue 10, pp 1981–1985 | Cite as

Low-pressure hydrocephalus: indication for custom-made catheters? Technical report

  • L. GalbarriatuEmail author
  • M. Rivero-Garvía
  • M. Olivares
  • D. Miranda
  • I. Pomposo
  • J. Márquez-Rivas
Technical Note - Neurosurgical Techniques

Abstract

Background

Low-pressure hydrocephalus (LPH) is characterized by ventriculomegaly with persistent low intracranial pressure (ICP). Sub-zero drainage is needed for its management and multiple solutions have been described. Our aim is to report our experience with custom-made peritoneal catheters with larger inner diameter as an alternative treatment option.

Methods

We made a retrospective review of all patients diagnosed with LPH and treated with custom-made peritoneal catheters at the Virgen del Rocío Pediatric Neurosurgical Unit. Catheters were coated with antibiotic or silver. The inner diameter of ventricular catheters was 1.4 mm; peritoneal catheters were larger than usual (1.9 mm inner diameter).

Results

We identified four patients in whom five custom-made peritoneal catheters were used over a 3-year period. There were two males and the mean age was 10 years (6 months–17 years). In all patients, placement of an EVD was necessary for sub-zero drainage, with maximum negative pressure of −8 cm H20. The mean time of maintenance of EVD was 102 days (10 days–1 year). Finally, three ventriculoperitoneal (VP) valveless systems, one with antigravitation device, and one Pro-GAV VP shunt were placed, all of them with larger custom-made peritoneal catheters. After a mean follow-up period of 2.3 years (6 months–3 years), two patients are completely recovered, one patient is partially dependent for daily activities with good cognitive status, and the last one is a child who died due to his brain tumor.

Conclusion

The custom-made peritoneal catheters with larger inner diameter could be a good option for the management of this complex pathology.

Keywords

Custom-made catheters Low pressure hydrocephalus Treatment 

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • L. Galbarriatu
    • 1
    • 4
    Email author
  • M. Rivero-Garvía
    • 2
  • M. Olivares
    • 2
  • D. Miranda
    • 3
  • I. Pomposo
    • 1
  • J. Márquez-Rivas
    • 2
  1. 1.Neurosurgery DepartmentCruces University HospitalBilbaoSpain
  2. 2.Neurosurgery DepartmentVirgen del Rocío University HospitalSevilleSpain
  3. 3.Neurosurgery DepartmentComplejo Hospitalario SalamancaSalamancaSpain
  4. 4.Neurosurgery DepartmentCruces University HospitalBarakaldoSpain

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