Advertisement

Therapie des Hydrozephalus

  • W. Wagner
Chapter

Zusammenfassung

Beim Hydrozephalus handelt es sich um ein Missverhältnis zwischen der Bildung und dem Abtransport des Liquors mit einem Zuviel an Produktion und/oder einem Zuwenig an Resorption. Beim Patienten, der dies (ohne Therapie) überlebt, besteht dieses Missverhältnis nur für eine gewisse Zeit und pendelt sich schließlich auf einem höheren Druckniveau (mit entsprechenden klinischen Symptomen) wieder ein. Dieses Missverhältnis entsteht durch Störung der Liquorresorption selbst oder durch eine Behinderung der Liquorzirkulation von den Orten der Produktion (Plexus choroidei) zu den Orten der Resorption (Pacchionische Granulationen, Spinalkanal etc.). Prinzipiell besteht die Therapie darin, entweder – in seltenen Fällen – die Liquorproduktion zu drosseln oder – bei weitem am häufigsten – die Liquorresorption wieder zu ermöglichen, entweder an den natürlichen Resorptionsorten oder in anderen Körperhöhlen.

Literatur

  1. Albright AL, Tyler-Kabara E (2001) Slit-ventricle syndrome secondary to shunt-induced suture ossification. Neurosurgery 48:764–770PubMedGoogle Scholar
  2. Aschoff A, Kremer P, Benesch C, Fruh K, Klank A, Kunze S (1995) Overdrainage and shunt technology. A critical comparison of programmable, hydrostatic and variable-resistance valves and flow-reducing devices. Child's Nerv Syst 11:193–202CrossRefGoogle Scholar
  3. Baird LC, Mazzola CA, Auguste KI, Klimo P Jr, Flannery AM; Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 5: Effect of valve type on cerebrospinal fluid shunt efficacy. J Neurosurg Pediatr 14(Suppl 1):35–43CrossRefGoogle Scholar
  4. Chari A, Czosnyka M, Richards HK, Pickard JD, Czosnyka ZH (2014) Hydrocephalus shunt technology: 20 years of experience from the Cambridge Shunt Evaluation Laboratory. J Neurosurg 120:697–707CrossRefGoogle Scholar
  5. Chumas PD, Kulkarni AV, Drake JM, Hoffman HJ, Humphreys RP, Rutka JT (1993) Lumboperitoneal shunting: a retrospective study in the pediatric population. Neurosurgery 32:376–383CrossRefGoogle Scholar
  6. Cinalli G, Spennato P, Del Basso de Caro ML, Buoncuore MC (2005) Hydrocephalus and the Dandy-Walker Malformation. In: Cinalli G, Maixner WJ, Saint-Rose C (Hrsg) Pediatric Hydrocephalus. Springer, Milano, 259–277CrossRefGoogle Scholar
  7. Cinalli G, Spennato P, Savarese L, Ruggiero C, Aliberti F, Cuomo L, Cianciulli E, Maggi G (2006) Endoscopic aqueductoplasty and placement of a stent in the cerebral aqueduct in the management of isolated fourth ventricle in children. J Neurosurg (Pediatrics) 104(Suppl 1):21–27CrossRefGoogle Scholar
  8. Czosnyka Z, Czosnyka M, Richards HK, Pickard JD (1998) Posture-related overdrainage: comparison of the performance of 10 hydrocephalus shunts in vitro. Neurosurgery 42:327–333CrossRefGoogle Scholar
  9. Drake JM, Sainte-Rose C (1995) The Shunt Book. Blackwell Science, Cambridge/MassGoogle Scholar
  10. Engel M, Carmel PW, Chutorian AM (1979) Increased intraventricular pressure without ventriculomegaly in children with shunts: „normal volume“ hydrocephalus. Neurosurgery 5:549–552CrossRefGoogle Scholar
  11. Eymann R, Steudel WI, Kiefer M (2009) Infection rate with application of an antibiotic-impregnated catheter for shunt implantation in children – a retrospective analysis. Klin Pädiatr 221:69–73CrossRefGoogle Scholar
  12. Fritsch MJ, Mehdorn M (2002) Endoscopic intraventricular surgery for treatment of hydrocephalus and loculated CSF space in children less than one year of age. Pediatr Neurosurg 36:183–188CrossRefGoogle Scholar
  13. Gruber R (1987) Das Schlitz-Ventrikel-Syndrom. Die hydrostasebedingten Shuntkomplikationen des kindlichen Hydrozephalus. Hippokrates, StuttgartGoogle Scholar
  14. Haberl EJ, Messing-Juenger M, Schuhmann M, Eymann R, Cedzich C, Fritsch MJ, Kiefer M, Van Lindert EJ, Geyer C, Lehner M, Rohde V, Stroux A, von Berenberg P (2009) Experiences with a gravity-assisted valve in hydrocephalic children. Clinical article. J Neurosurg (Pediatrics) 4:289–294CrossRefGoogle Scholar
  15. Hanlo PW, Cinalli G, Vandertop WP, Faber JA, Bogeskov L, Borgesen SE, Boschert J, Chumas P, Eder H, Pople IK, Serlo W, Vitzthum E (2003) Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used. J Neurosurg 99:52–57CrossRefGoogle Scholar
  16. Harter DH (2004) Management strategies for treatment of the trapped fourth ventricle. Child's Nerv Syst 20:710–716CrossRefGoogle Scholar
  17. Iskandar BJ, McLaughlin C, Mapstone TB, Grabb PA, Oakes WJ (1998) Pitfalls in the diagnosis of ventricular shunt dysfunction: radiology reports and ventricular size. Pediatrics 101:1031–1036CrossRefGoogle Scholar
  18. Kehler U, Kiefer M, Eymann R, Wagner W, Tschan C, Langer N, Rohde V, Ludwig H, Gliemroth J, Meier U, Lemcke J, Thomale UW, Fritsch M, Krauss JK, Mirzayan MJ, Schuhmann M, Huthmann A (2015) PROSAIKA: A Prospective Multicenter Registry with the First Programmable Gravitational Device for Hydrocephalus Shunting. Clinical Neurology and Neurosurgery 137:132–136CrossRefGoogle Scholar
  19. Klimo P Jr, Thompson CJ, Baird LC, Flannery AM (2014a) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 7: Antibiotic-impregnated shunt systems versus conventional shunts in children: a systematic review and meta-analysis. J Neurosurg Pediatrics (Suppl) 14: 53–59CrossRefGoogle Scholar
  20. Klimo P Jr, Van Poppel M, Thompson CJ, Baird LC, Duhaime AC, Flannery AM; Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force (2014b) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 6: Preoperative antibiotics for shunt surgery in children with hydrocephalus: a systematic review and meta-analysis. J Neurosurg Pediatr 14(Suppl 1): 44–52Google Scholar
  21. Le H, Yamini B, Frim DM (2002) Lumboperitoneal shunting as a treatment for slit ventricle syndrome. Pediatr Neurosurg 36:178–182CrossRefGoogle Scholar
  22. Lee L, King NK, Kumar D, Ng YP, Rao J, Ng H, Lee KK, Wang E, Ng I (2014) Use of programmable versus nonprogrammable shunts in the management of hydrocephalus secondary to aneurysmal subarachnoid hemorrhage: a retrospective study with cost-benefit analysis. J Neurosurg 121:899–903CrossRefGoogle Scholar
  23. Libenson MH, Kaye EM, Rosman NP, Gilmore HE (1999) Acetazolamide and furosemide for posthemorrhagic hydrocephalus of the newborn. Pediatr Neurol 20: –185–191CrossRefGoogle Scholar
  24. Mazzola CA, Choudhri AF, Auguste KI, Limbrick DD Jr, Rogido M, Mitchell L, Flannery AM; Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 2: Management of posthemorrhagic hydrocephalus in premature infants. J Neurosurg Pediatr 14(Suppl1): 8–23CrossRefGoogle Scholar
  25. Reinprecht A, Dietrich W, Berger A, Bavinzski G, Weninger M, Czech T (2001) Posthemorrhagic hydrocephalus in preterm infants: long-term follow-up and shunt-related complications. Child's Nerv Syst 17:663–669CrossRefGoogle Scholar
  26. Rekate HL (1993) Classification of slit-ventricle syndromes using intracranial pressure monitoring. Pediatr Neurosurg 19:15–20CrossRefGoogle Scholar
  27. Spiegelman L, Asija R, Da Silva SL, Krieger MD, McComb JG (2014) What is the risk of infecting a cerebrospinal fluid-diverting shunt with percutaneous tapping? J Neurosurg Pediatr 14:336–339PubMedGoogle Scholar
  28. Tamber MS, Klimo P Jr, Mazzola CA, Flannery AM, Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 8: Management of cerebrospinal fluid shunt infection. J Neurosurg Pediatr 14(Suppl 1):60–71CrossRefGoogle Scholar
  29. Tschan CA, Antes S, Huthmann A, Vulcu S, Oertel J, Wagner W (2014) Overcoming CSF overdrainage with the adjustable gravitational valve proSA. Acta Neurochir 156:767–776CrossRefGoogle Scholar
  30. Tuli S, Drake J, Lawless J, Wigg M, Lamberti-Pasculli M (2000) Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg 92:31–38CrossRefGoogle Scholar
  31. Welschehold S, Schmalhausen E, Dodier P, Vulcu S, Oertel J, Wagner W, Tschan CA (2012) First clinical results with a new telemetric intracranial pressure-monitoring system. Neurosurgery 70:44–49PubMedGoogle Scholar
  32. Zhu X, Di Rocco C (2013) Choroid plexus coagulation for hydrocephalus not due to CSF overproduction: a review. Childs Nerv Syst 29:35–42CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  1. 1.Pädiatrische NeurochirurgieUniversitätsmedizin MainzMainzDeutschland

Personalised recommendations