Journal article
It’s not always the shunt: Microthombi formation in venous collaterals causing symptoms of shunt failure in the setting of shunted hydrocephalus
Clinical neurology and neurosurgery, v 209, 106932
Oct 2021
PMID: 34509140
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
We present a patient with a history of shunted hydrocephalus due to neonatal iatrogenic thoracic venous occlusion with subsequent interval development of spontaneous thoracic venous collateral occlusion as a young adult presenting with symptoms of ventriculoperitoneal shunt failure. Though the patient’s presenting symptoms were suggestive of shunt failure in the setting of known shunt dependent hydrocephalus, specific ophthalmologic findings, including venous engorgement, retinal and subconjunctival hemorrhages as well as periorbital edema in conjunction with papilledema, led to the correct diagnosis of cranio-orbital congestion secondary to microthrombi formation in the venous collateral anomalies of her chest wall. This pathology was successfully managed with warfarin.
•Venous anomalies are a predisposition to impaired cerebrospinal fluid absorption.•Microthombi formation in the venous system may impair cerebrospinal fluid flow.•Venous congestion causing hydrocephalus may be managed with anticoagulation.
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Details
- Title
- It’s not always the shunt: Microthombi formation in venous collaterals causing symptoms of shunt failure in the setting of shunted hydrocephalus
- Creators
- Joshua T.M. Lucas - Drexel UniversityNathan Esplin - Allegheny General HospitalErik M. Happ - Allegheny General HospitalJody Leonardo - Allegheny General Hospital
- Publication Details
- Clinical neurology and neurosurgery, v 209, 106932
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000704947800014
- Scopus ID
- 2-s2.0-85114445402
- Other Identifier
- 991019168330004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery