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Outcomes and Experience with Lumbopleural Shunts in the Management of Idiopathic Intracranial Hypertension.

Publication ,  Journal Article
Elder, BD; Sankey, EW; Goodwin, CR; Jusué-Torres, I; Khattab, MH; Rigamonti, D
Published in: World Neurosurg
August 2015

OBJECTIVE: To report five patients who underwent lumbopleural (LPl) shunting for the treatment of idiopathic intracranial hypertension (IIH) and to describe the considerations, complications, and outcomes related to this rarely described procedure. METHODS: The clinical data of five patients treated with LPl shunting over a 23-year period were retrospectively analyzed. Factors including the age at diagnosis of IIH, age at time of LPl shunting, body mass index (BMI), reason for LPl shunt placement, number of revisions before LPl shunt placement, valve type, time to first revision, presence of overdrainage and its management, complications and their management, survival time of LPl shunt, and clinical course at last follow-up were analyzed. RESULTS: All patients were morbidly obese females with an average of 4.6 shunt revisions before an LPl shunt. The average overall survival time of the LPl shunt was 48 months. Two patients experienced failure of their LPl shunts with subsequent replacement within the first year. Four patients experienced complications related to shunt overdrainage, requiring placement of an antisiphon device (ASD) or additional valve. One patient developed a symptomatic pleural effusion, and one patient developed a small pneumothorax, which was managed conservatively. CONCLUSIONS: LPl shunting, though rarely used, is a viable option in the treatment of IIH refractory to standard peritoneal shunting. When pursuing this treatment, a valve and ASD are recommended to mitigate the risks of overdrainage and pleural effusion. Chest imaging should be obtained if the patient becomes symptomatic but can be deferred if the patient remains asymptomatic and is doing well.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

August 2015

Volume

84

Issue

2

Start / End Page

314 / 319

Location

United States

Related Subject Headings

  • Young Adult
  • Ventriculoperitoneal Shunt
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Reoperation
  • Pseudotumor Cerebri
  • Patient Selection
  • Humans
  • Female
 

Citation

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Chicago
ICMJE
MLA
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Elder, B. D., Sankey, E. W., Goodwin, C. R., Jusué-Torres, I., Khattab, M. H., & Rigamonti, D. (2015). Outcomes and Experience with Lumbopleural Shunts in the Management of Idiopathic Intracranial Hypertension. World Neurosurg, 84(2), 314–319. https://doi.org/10.1016/j.wneu.2015.03.021
Elder, Benjamin D., Eric W. Sankey, C Rory Goodwin, Ignacio Jusué-Torres, Mohamed H. Khattab, and Daniele Rigamonti. “Outcomes and Experience with Lumbopleural Shunts in the Management of Idiopathic Intracranial Hypertension.World Neurosurg 84, no. 2 (August 2015): 314–19. https://doi.org/10.1016/j.wneu.2015.03.021.
Elder BD, Sankey EW, Goodwin CR, Jusué-Torres I, Khattab MH, Rigamonti D. Outcomes and Experience with Lumbopleural Shunts in the Management of Idiopathic Intracranial Hypertension. World Neurosurg. 2015 Aug;84(2):314–9.
Elder, Benjamin D., et al. “Outcomes and Experience with Lumbopleural Shunts in the Management of Idiopathic Intracranial Hypertension.World Neurosurg, vol. 84, no. 2, Aug. 2015, pp. 314–19. Pubmed, doi:10.1016/j.wneu.2015.03.021.
Elder BD, Sankey EW, Goodwin CR, Jusué-Torres I, Khattab MH, Rigamonti D. Outcomes and Experience with Lumbopleural Shunts in the Management of Idiopathic Intracranial Hypertension. World Neurosurg. 2015 Aug;84(2):314–319.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

August 2015

Volume

84

Issue

2

Start / End Page

314 / 319

Location

United States

Related Subject Headings

  • Young Adult
  • Ventriculoperitoneal Shunt
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Reoperation
  • Pseudotumor Cerebri
  • Patient Selection
  • Humans
  • Female