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Journal article
First-in-Human ExperienceWith Integration of a Hydrocephalus Shunt Device Within a Customized Cranial Implant
Operative neurosurgery (Hagerstown, Md.), v 17(6), pp 608-615
01 Dec 2019
PMID: 30753624
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Implantable shunt devices are critical and life saving for hydrocephalus patients. However, these devices are fraught with high complication rates including scalp dehiscence, exposure, and extrusion. In fact, high shunt valve profiles are correlated with increased complications compared to those with lower profiles. As such, we sought a new method for integrating shunt valves for those challenging patients presenting with scalp-related complications.
OBJECTIVE: To safely implant and integrate a hydrocephalus shunt valve device within a customized cranial implant, in an effort to limit its high-profile nature as a main contributor to shunt failure and scalp breakdown, and at the same time, improve patient satisfaction by preventing contour deformity.
METHODS: A 64-yr-old male presented with an extruding hydrocephalus shunt valve and chronic, open scalp wound. The shunt valve was removed and temporary shunt externalization was performed. He received 2 wk of culture-directed antibiotics. Next, a contralateral craniectomy was performed allowing a new shunt valve system to be implanted within a low-profile, customized cranial implant. All efforts were made, at the patient's request, to decrease the high-profile nature of the shunt valve contributing to his most recent complication.
RESULTS: First-in-human implantation was performed without complication. Postoperative shunt identification and programming was uncomplicated. The high-profile nature of the shunt valve was decreased by 87%. At 10 mo, the patient has experienced no complications and is extremely satisfied with his appearance.
CONCLUSION: This first-in-human experience suggests that a high-profile hydrocephalus shunt device may be safely integrated within a customized cranial implant.
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Details
- Title
- First-in-Human ExperienceWith Integration of a Hydrocephalus Shunt Device Within a Customized Cranial Implant
- Creators
- Chad R. Gordon - Johns Hopkins MedicineAmir Wolff - Johns Hopkins MedicineGabriel F. Santiago - Johns Hopkins MedicineKenneth Liebman - Drexel UniversityErol Veznedaroglu - Drexel UniversityFrank D. Vrionis - Boca Raton Regional HospitalJudy Huang - Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MarylandHenry Brem - Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MarylandMark Luciano - Department of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland
- Publication Details
- Operative neurosurgery (Hagerstown, Md.), v 17(6), pp 608-615
- Publisher
- Oxford Univ Press
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000507863100041
- Scopus ID
- 2-s2.0-85075044872
- Other Identifier
- 991019168562204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery