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Case Report

Anaesthetic Management of a Patient with Obstructive Hydrocephalus who had Undergone Craniectomy Posted for Ventriculoperitoneal Shunting

Kiran Nelamangala, Manikandan Chinnasamy, Ravi Madhusudhana, Shobbanna Manukaran

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Indian Journal of Anesthesia and Analgesia 12(2):p 125-128, April -June 2025. | DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.7

How Cite This Article:

Manikandan Chinnasamy, Ravi Madhusudhana, Kiran Nelamangala et al. Anaesthetic Management of a Patient with Obstructive Hydrocephalus who had Undergone Craniectomy Posted for Ventriculoperitoneal Shunting. Ind J Anesth Analg. 2025; 12(2): 125-128.

Timeline

Received : February 06, 2025         Accepted : April 05, 2025          Published : June 30, 2025

Abstract

Introduction: Hydrocephalus, it is an excessive accumulation of cerebrospinal fluid within the head. It can be due to congenital or acquired. It leads to increase in intracranial pressure, seizures, permanent disability and sudden death, for which patients has to undergo external ventricular drain, lumbar shunts or ventricular shunts. Patients with intracranial pathology have high risk of perioperative complications, which needs specific anaesthetic management. Case Report: A 32 year old male a case of status post right temporo-parietal craniectomy with obstructive hydrocephalus posted for ventriculo-peritoneal shunting. He sustained head injury 2 months back for which he had undergone craniectomy and also tracheostomised. Then he was newly diagnosed as diabetic and hypertensive for which he was on medication. And his blood investigations showed hyponatremia for which he was started on sodium correction. In between, he had developed left cephalic vein thrombosis for which he was started on injection Heparin. After 2 months of craniectomy he developed cerebral edema following which his GCS was also worsened. So ventriculoperitoneal shunting was done under general anaesthesia and it was uneventful. Conclusion: As the patient was posted for ventriculoperitoneal shunting with known history of status post craniectomy, hyponatremia and high blood sugars; early hemodynamic management and intensive care was extremely useful to these patient in view of anticipation of seizures, bleeding. In this case, the anaesthetic management was handled successfully without any consequences. Key Messages: In patients with increased intracranial pressures due to various reasons, shunting is advised to reduce the pressures by draining the excess cerebrospinal fluid into the peritoneum. This gives temporary relief to the brain, reducing the edema and reversing the effects of increased pressures in the central nervous system. Our patient was a post traumatic case presented with hyponatremia requiring ventriculo-peritoneal shunt. We had to correct the hyponatremia anticipating convulsions, utmost care was taken perioperatively with a successful outcome.

References

  • 1.   Krovvidi H., Flint G., Williams AV. Perioperative management of hydrocephalus. BJA education. 2018; 18(5): 140-6.
  • 2.   Nienaber J. Anaesthesia for ventriculoperitoneal shunts. Southern African Journal of Anaesthesia and Analgesia. 2011; 17(1): 73-5.
  • 3.   Aoki N. Lumboperitoneal shunt: clinical applications, complications, and comparison with ventriculoperitoneal shunt. Neurosurgery. 1990; 26(6): 998-1004.
  • 4.   Hamouda A.M., Pennington Z., Shafi M., Potes M.D., Hallak H., Graff-Radford J., Jones D.T., Botha H., Cutsforth-Gregory J.K., Cogswell P.M., Elder B.D. Ventriculoperitoneal Shunt Placement Safety in Idiopathic Normal Pressure Hydrocephalus: Anticoagulated Versus Non–Anticoagulated Patients. World neurosurgery. 2024; 186: e622-9.
  • 5.   Gutierrez J.J., Rocuts K.R. Perioperative anticoagulation management. StatPearls [Internet]. 2023 Jan 23.

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.

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Cite this article

Manikandan Chinnasamy, Ravi Madhusudhana, Kiran Nelamangala et al. Anaesthetic Management of a Patient with Obstructive Hydrocephalus who had Undergone Craniectomy Posted for Ventriculoperitoneal Shunting. Ind J Anesth Analg. 2025; 12(2): 125-128.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

Received Accepted Published
February 06, 2025 April 05, 2025 June 30, 2025
DOI: https://doi.org/10.21088/ijaa.2349.8471.12225.7

Keywords

CrainectomyHydrocephalusVentriculoperitoneal shunting

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Timeline

Received February 06, 2025
Accepted April 05, 2025
Published June 30, 2025

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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