Ventricular enlargement due to acute hypernatremia in a patient with a ventriculoperitoneal shunt

Andres, Robert H; Pendharkar, Arjun V; Kuhlen, Dominique; Mariani, Luigi (2010). Ventricular enlargement due to acute hypernatremia in a patient with a ventriculoperitoneal shunt. Journal of neurosurgery, 113(1), pp. 82-4. Charlottesville, Va.: American Association of Neurological Surgeons 10.3171/2009.10.JNS09845

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Patients requiring CSF shunts frequently have comorbidities that can influence water and electrolyte balances. The authors report on a case involving a ventriculoperitoneal shunt in a patient who underwent intravenous hyperhydration and withdrawal of vasopressin substitution prior to scheduled high-dose chemotherapy regimen for a metastatic suprasellar germinoma. After acute neurological deterioration, the patient underwent CT scanning that demonstrated ventriculomegaly. A shunt tap revealed no flow and negative opening pressure. Due to suspicion of proximal shunt malfunction, the comatose patient underwent immediate surgical exploration of the ventricle catheter, which was found to be patent. However, acute severe hypernatremia was diagnosed during the procedure. After correction of the electrolyte disturbances, the patient regained consciousness and made a good recovery. Although rare, the effects of acute severe hypernatremia on brain volume and ventricular size should be considered in the differential diagnosis of ventriculoperitoneal shunt failure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Andres, Robert; Kuhlen, Dominique and Mariani, Luigi

ISSN:

0022-3085

Publisher:

American Association of Neurological Surgeons

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:07

Last Modified:

06 Dec 2013 13:19

Publisher DOI:

10.3171/2009.10.JNS09845

PubMed ID:

19911884

Web of Science ID:

000279107300020

URI:

https://boris.unibe.ch/id/eprint/194 (FactScience: 196872)

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