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279549

Evaluation of Connecting a Fourth Ventricular Catheter with Y Connector to a Previous Ventriculoperitoneal Shunt, as a Treatment Option for Patients with Symptomatic Trapped Four

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Last updated: 03 Jan 2025

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Abstract

Background: Trapped fourth ventricle (TFV) is a rare clinico-pathological syndrome, usually resulting from inflammatory conditions (post-infective and post-hemorrhagic) that may present with serious brain stem compression manifestations. Many treatment modalities have been described with varying degrees of success. Objectives: To evaluate our results in managing the trapped 4th ventricle by inserting 4th ventricular catheter and connecting it to the previously implanted ventriculoperitoneal (VP) shunt via Y connector. Patients and Methods: A total number of 12 cases with TFV were diagnosed and treated surgically between 2014 and 2021 by a fourth ventricular catheter and connection to the pre-existing shunt via a Y- connector. Preoperative clinical and radiological findings were reported. Postoperative improvement was evaluated during a mean follow-up of 4.3 years. Postoperative complications were reported Results: 12 patients (6 males and 6 females), with a mean age of 3.3 years diagnosed with trapped fourth ventricles were included. All patients had previous VP shunts. Headache, vomiting, abnormal movement, gait disturbance, and nystagmus were the common symptoms. Trapped fourth ventricle was post-infectious in 6 (50%) patients, post-hemorrhagic in 4 (33.3%) patients, and congenital in 2 (16.7%) patients. 6 (50%) patients had preoperative slit lateral ventricles and 4 (33.3%) had multiloculated hydrocephalus. Postoperatively 10 (83.3%) patients had clinical improvement while 2 (16.7%) remained as preoperative. All patients had a decrease in the 4th ventricular size. Complications of surgery were minor. Conclusion: Fourth ventricular shunting with a Y connector is a valuable and effective modality of treatment in TFV, especially when other methods fail or in specific complex pathological situations, with fewer complications.

DOI

10.21608/ejhm.2023.279549

Authors

First Name

Mohammed Hammad

Last Name

Eltantawy

MiddleName

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Affiliation

Department of Neurosurgery, Faculty of Medicine, Benha University, Egypt

Email

hammad_neurosurg@yahoo.com

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First Name

Shawky A.

Last Name

Elmeleigy

MiddleName

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Affiliation

Department of Neurosurgery, Faculty of Medicine, Benha University, Egypt

Email

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City

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Orcid

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First Name

Ahmad

Last Name

Arab

MiddleName

-

Affiliation

Department of Neurosurgery, Faculty of Medicine, Benha University, Egypt

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-

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Orcid

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Volume

90

Article Issue

1

Related Issue

38787

Issue Date

2023-01-01

Receive Date

2023-01-10

Publish Date

2023-01-01

Page Start

300

Page End

307

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_279549.html

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https://ejhm.journals.ekb.eg/service?article_code=279549

Order

44

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Evaluation of Connecting a Fourth Ventricular Catheter with Y Connector to a Previous Ventriculoperitoneal Shunt, as a Treatment Option for Patients with Symptomatic Trapped Four

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Article

Created At

22 Jan 2023