López JTA, Salazar PJR

Language: Spanish
References: 15
Page: 179-186
PDF size: 446.56 Kb.

ABSTRACT

Introduction. Hydrocephalus is an enlargement of the ventricular system associated with intracranial hypertension. It is caused by an imbalance between production and reabsorption of cephalorachidian fluid which is classified as communicating and non-communicating. The initial treatment of choice for hydrocephalus is draining through ventriculoperitoneal shunt (VPS) catheters; for this reason, in the radiological report it is indispensable to specify their location, whether in cases of dysfunction or control.
Purpose. Determine the usefulness of cranial CT imaging for VPS evaluation in patients with hydrocephalus and evaluate craniometric characteristics in relation to their location.
Material and methods. Issues relating to the approach from the craniotomy site, whether parietal, frontal, or occipital, in relation to bone references and the ventricular end of the VPS catheter were evaluated.
Results. Of 90 cranial computed tomographies evaluated, 15 were from patients with two ventricular drainage catheters; the other 75 had unilateral catheters. The parietal approach was the most common (80%) and the bilateral and frontal approaches the least (20%).
Discussion. Our study determined that there is a predominant preference for parietal placement of peritoneal ventricular drainage catheters. However, that approach causes wide variability of the craniotomy site in relation to the Dandy point, the angle of the catheter path, and its intracranial length. On the other hand, frontal approaches (which were the least used) showed greater accuracy in relation to the Kocher point and less variability of catheter path angles and length, as described in the literature. Independently of the type of approach, most of the catheters located their end in the body of the ventricle, which, although not ideal, is acceptable provided the catheter drains and is functional.

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