Brain ventricle index evaluation after Ina-Shunt implantation in congenital hydrocephalus patients

Yoka Mahendra Prana; Dian Prasetyo Wibisono; Endro Basuki; Handoyo Pramusinto; Muhammad Arifin Parenrengi; Samsul Azhari; Rachmat Andi Hartanto

doi:10.15562/ijn.v5i3.221

Brain ventricle index evaluation after Ina-Shunt implantation in congenital hydrocephalus patients

Yoka Mahendra Prana ,

Dian Prasetyo Wibisono ,

Endro Basuki ,

Handoyo Pramusinto ,

Muhammad Arifin Parenrengi ,

Samsul Azhari ,

Rachmat Andi Hartanto ,

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DOI: https://doi.org/10.15562/ijn.v5i3.221 |
Published: 2022-09-02

Abstract

Background: One of the management of hydrocephalus is using a shunt system. At the end of 1980, a self-made pumping system with two semilunar valves was built to ensure the cerebrospinal fluid flows in one direction. In November 2016, the production of the shunt system with a semilunar valve was made by a different manufacturer by the name of Ina-Shunt. The product has the same working system as before, and the production mode is similar. Further assessment of this new product needs to be done. Calculating the Evans ratio in the radiological examination can be used to assess its effectiveness in the treatment of hydrocephalus. This study examines the Evans ratio changes in patients who underwent ventriculoperitoneal (VP) shunt using Ina-Shunt.

Methods: This study was a prospective experimental study conducted on patients diagnosed with congenital communicating hydrocephalus who underwent VP shunt surgery using an Ina-Shunt device in Yogyakarta, Surabaya, and Jakarta. The ventricular index (Evans ratio) of pre- and two-week postoperative patients was calculated using head computed tomography scan software. The data was then statistically analyzed using paired t-test.

Results: Thirty-one subjects with congenital communicating hydrocephalus underwent VP shunt using Ina-Shunt in Yogyakarta, Jakarta, and Surabaya. There was a significant difference between the preoperative Evans ratio value of 0.62 + 0.016 and the post-operative Evans ratio of 0.59 + 0.015 (p < 0.05).

Conclusion: There was a change in brain ventricle index that showed in decreasing Evans ratio after VP shunt surgery using Ina-Shunt in pediatrics diagnosed with congenital communicating hydrocephalus. A larger sample and longer follow-up were needed for serial Evans ratio changes.

References

Drake, James M., and Christian Sainte-Rose. The Shunt Book. Cambridge, Mass: Blackwell Science, 1995.
Sudiharto, P. Terapi Pembedahan pada Hidrosefalus Bayi dan Anak dengan Sistem Pirau Katup Semiluner Ventrikuloperitoneal. Universitas Gadjah Mada. 2004.
Jallo, George., Korthbauer Karl, Violette M. Handbook of Pediatric Neurosurgery. New York: Thieme. 2018
Greenberg, M. S. Handbook of Neurosurgery 9th ed. New York: Thieme. 2020
Portillo Medina SA, Franco JVA, Ciapponi A, Garrote V, Vietto V. Ventriculoperitoneal shunting device for hydrocephalus. Cochrane Database of Systematic Reviews, Issue 7. 2017. DOI 10.1002/14651858.CD012726.pub2
Baird, C. Lisa, Mazzola, A. Catherine. Pediatric hydrocephalus: systematic literature review and evidence based guidelines. Part 5: effect of valve type on cerebrospinal fluid shunt efficacy. J Neurosurg Pediatrics. 2014.14;35-43. DOI: 10.3171/2014.7.peds14325
Kestle, J., Drake, J. M., Milner, R., Sainte-Rose, C., Cinalli, G., Boop, F. Long-Term Follow-Up Data from the Shunt Design Trial. Pediatr Neurosurg. 2000. 33, 230–236. DOI: 10.1159/000055960
Nikas, C. Dimitrios, Alexander. Pediatric Hydrocephalus; systematic literature review and evidence based guidelines. Part 10: change in ventricle size as a measurement of effective treatment of hydrocephalus. J Neurosurg Pediatrics. 2014 14;77-81. DOI: 10.3171/2014.7.peds14330
Kamenova, M., Rychen, J., Guzman, R., Mariani, L., Soleman, J . Yield of early postoperative computed tomography after frontal ventriculoperitoneal shunt placement. PloS one. 2018. 13(6). DOI: 10.1371/journal.pone.0198752
O’Hayon, B. B., Drake, J. M., Ossip, M. G., Tuli, S., & Clarke, M. Frontal and Occipital Horn Ratio: A Linear Estimate of Ventricular Size for Multiple Imaging Modalities in Pediatric Hydrocephalus. Pediatric Neurosurgery. 1998. 29(5), 245–249. DOI: 10.1159/000028730
Hasanin, T.M., Mansour, S.A., Alemam, S.E., Alnoamany H.A.,Eldien M.L. Ventricular Volume Changes After Succesful Shunting in Hydrocephalic Infants. Egyptian Journal of Neurosurgery. 2020. 35:10. DOI: 10.1186/s41984-020-00075-w
Evans A. W., An Encephalographic Ratio for Estimating Ventricular Enlargement and Cerebral Atrophy. 1942. Detroit.

[1] Drake, James M., and Christian Sainte-Rose. The Shunt Book. Cambridge, Mass: Blackwell Science, 1995.

[2] Sudiharto, P. Terapi Pembedahan pada Hidrosefalus Bayi dan Anak dengan Sistem Pirau Katup Semiluner Ventrikuloperitoneal. Universitas Gadjah Mada. 2004.

[3] Jallo, George., Korthbauer Karl, Violette M. Handbook of Pediatric Neurosurgery. New York: Thieme. 2018

[4] Greenberg, M. S. Handbook of Neurosurgery 9th ed. New York: Thieme. 2020

[5] Portillo Medina SA, Franco JVA, Ciapponi A, Garrote V, Vietto V. Ventriculoperitoneal shunting device for hydrocephalus. Cochrane Database of Systematic Reviews, Issue 7. 2017. DOI 10.1002/14651858.CD012726.pub2

[6] Baird, C. Lisa, Mazzola, A. Catherine. Pediatric hydrocephalus: systematic literature review and evidence based guidelines. Part 5: effect of valve type on cerebrospinal fluid shunt efficacy. J Neurosurg Pediatrics. 2014.14;35-43. DOI: 10.3171/2014.7.peds14325

[7] Kestle, J., Drake, J. M., Milner, R., Sainte-Rose, C., Cinalli, G., Boop, F. Long-Term Follow-Up Data from the Shunt Design Trial. Pediatr Neurosurg. 2000. 33, 230–236. DOI: 10.1159/000055960

[8] Nikas, C. Dimitrios, Alexander. Pediatric Hydrocephalus; systematic literature review and evidence based guidelines. Part 10: change in ventricle size as a measurement of effective treatment of hydrocephalus. J Neurosurg Pediatrics. 2014 14;77-81. DOI: 10.3171/2014.7.peds14330

[9] Kamenova, M., Rychen, J., Guzman, R., Mariani, L., Soleman, J . Yield of early postoperative computed tomography after frontal ventriculoperitoneal shunt placement. PloS one. 2018. 13(6). DOI: 10.1371/journal.pone.0198752

[10] O’Hayon, B. B., Drake, J. M., Ossip, M. G., Tuli, S., & Clarke, M. Frontal and Occipital Horn Ratio: A Linear Estimate of Ventricular Size for Multiple Imaging Modalities in Pediatric Hydrocephalus. Pediatric Neurosurgery. 1998. 29(5), 245–249. DOI: 10.1159/000028730

[11] Hasanin, T.M., Mansour, S.A., Alemam, S.E., Alnoamany H.A.,Eldien M.L. Ventricular Volume Changes After Succesful Shunting in Hydrocephalic Infants. Egyptian Journal of Neurosurgery. 2020. 35:10. DOI: 10.1186/s41984-020-00075-w

[12] Evans A. W., An Encephalographic Ratio for Estimating Ventricular Enlargement and Cerebral Atrophy. 1942. Detroit.

Brain ventricle index evaluation after Ina-Shunt implantation in congenital hydrocephalus patients

Abstract

References

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