Clinical outcomes of temporary shunting for infants with cerebral pseudomeningocele.

Published

Journal Article

OBJECTIVE: Although in the case of subdural collections temporary shunting has been suggested as a viable alternative for definitive drainage of the accumulated fluid until restoration of the normal CSF dynamics, there is no agreement on the best management strategy for pseudomeningocele. METHODS: The authors performed a retrospective chart review in order to evaluate the clinical outcomes of infants temporarily shunted for pseudomeningocele without encephalocele at our institution (The University of Illinois at Peoria/Illinois Neurological Institute) in the period from 2004 to 2012. The epidemiological characteristics, clinical management, and final outcomes of such subpopulation were compared with a control group which received temporary shunting for subdural hematomas (SDH) during the same period. RESULTS: Four patients (100% male) ranging in age from 8.9 to 27.1 months (mean = 13.88) with pseudomeningocele and 17 patients (64.7% male) ranging in age from 1.9 to 11.8 months (mean = 4.15) with SDH were identified. Although the initial management included sequential percutaneous subdural tapping in 82% of the patients, all children ultimately failed such strategy, requiring either subdural-peritoneal (81% of the cases) or subgaleal-peritoneal (19% of the cases) shunting. The mean implant duration was 201 days for the pseudomeningocele group and 384 days for the SDH one. Mean post-shunt hospitalization was 2 days for patients with pseudomeningocele and 4 days for patients with SDH. There was no statistical difference in terms of complications, length of hospitalization post-shunting, or clinical outcomes between the patients with pseudomeningocele and those with SDH. CONCLUSIONS: Temporary shunting of infants with pseudo-meningocele constitutes a viable therapeutic alternative with favorable clinical outcomes and a low risk of shunt dependency similar to those of children with SDH.

Full Text

Cited Authors

  • Mattei, TA; Sambhara, D; Bond, BJ; Lin, J

Published Date

  • February 2014

Published In

Volume / Issue

  • 30 / 2

Start / End Page

  • 283 - 291

PubMed ID

  • 23881425

Pubmed Central ID

  • 23881425

Electronic International Standard Serial Number (EISSN)

  • 1433-0350

Digital Object Identifier (DOI)

  • 10.1007/s00381-013-2230-5

Language

  • eng

Conference Location

  • Germany