Individualized Management of Subdural Effusion-Hematoma in Pediatric Shunt Patients

Authors : Derya Karaoğlu Gündoğdu, Burak Gezer

Pages : 214-219

View : 38 | Download : 99

Publication Date : 2023-10-15

Article Type : Research Paper

Abstract :AİM This study examines the challenges of managing subdural effusion-hematoma (SEH) following shunt procedures for treating hydrocephalus in a pediatric population. It raises questions about the effectiveness of fixed-pressure versus adjustable shunts, particularly in the management of SEH complications. While adjustable shunts have been lauded for their flexibility, neither option has fully eradicated the risk of SEH. The study aims to share clinical insights into managing these complications, given the lack of a one-size-fits-all solution. MATERİAL AND METHODS This study retrospectively analyzes data from 2011 to 2022 on 496 pediatric patients who underwent ventriculoperitoneal (VP) shunt surgery for hydrocephalus at the same hospital. The study focuses on 11 patients with shunt-related subdural effusion-hematoma (SEH). RESULTS This detailed study on 11 pediatric patients who developed subdural effusion-hematoma (SEH) after shunt placement reveals a diverse range of symptoms and treatments. Asymptomatic patients were closely monitored, while those with shunt infections had their shunts removed and underwent extra-ventricular drainage (EVD). In more severe cases, such as reduced consciousness, emergency interventions like shunt removal and hematoma surgery were performed. The outcomes varied, but many patients showed improvements and some were even able to continue without a shunt, based on individualized assessments and treatments. CONCLUSION: The study concludes that managing SEH in pediatric patients post-shunt placement is complex and individualized, emphasizing that treatment should be symptom-based rather than solely relying on radiological findings, thereby filling a gap in the literature that mostly focuses on adults.
Keywords : hidrosefali, şant, subdural efüzyon, subdural hematom, pediatrik