abstract = vp malfuctions /peds acm impacted

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abstract = vp malfuctions /peds acm impacted

Postby Sarah in Paradise » Mon Oct 05, 2009 11:02 am

Grettings = I just posted this abstract on the main board area = ( hope to save time reading for any who saw it there ) . Thought posting it to peds seemed appropriate too .( please remove it if needed moderator = not sure if I'm "double posting ".


I ran across the following abstract today == may be of some help to those with vp shunt /and acm 1/ not decompressed - explaining some factors that can be involved , and could be of help in getting attention =consideration of acm impacts ect. for peds patients . NOTE too = the authors are in NY = seem to have awareness /experience in VP shunt /acm situations, - has anyone seen this team of physicians or got insight to share ?

: J Neurosurg Pediatr. 2009 Aug;4(2):170-5.Click here to read Links
Shunt malfunction causing acute neurological deterioration in 2 patients with previously asymptomatic Chiari malformation Type I. Report of two cases.
Elliott R, Kalhorn S, Pacione D, Weiner H, Wisoff J, Harter D.

Department of Neurosurgery, New York University Medical Center, New York, NY, USA. robert.elliot@nyumc.org

Patients with symptomatic Chiari malformation Type I (CM-I) typically exhibit a chronic, slowly progressive disease course with evolution of symptoms. However, some authors have reported acute neurological deterioration in the setting of CM-I and acquired Chiari malformations. Although brainstem dysfunction has been documented in patients with CM-II and hydrocephalus or shunt malfunction, to the authors' knowledge only 1 report describing ventriculoperitoneal (VP) shunt malfunction causing neurological deterioration in a patient with CM-I exists. The authors report on their experience with the treatment of previously asymptomatic CM-I in 2 children who experienced quite different manifestations of acute neurological deterioration secondary to VP shunt malfunction. Presumably, VP shunt malfunction created a positive rostral pressure gradient across a stenotic foramen magnum, resulting in tetraparesis from foramen magnum syndrome in 1 patient and acute ataxia and cranial nerve deficits from syringobulbia in the other. Although urgent shunt revisions yielded partial recovery of neurological function in both patients, marked improvement occurred only after posterior fossa decompression.

PMID: 19645553 [PubMed - in process
Sarah in Paradise
 
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