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Ventriculosubgaleal shunt의 임상적 경험
남궁원철,박상근,김태홍,신형식,황용순,김상진 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Object : Ventriculosubgaleal(VSG) shunt is considered to be useful and safe ventricluar diversion method for the patient for whom ventriculoperitoneal(VP) shunt cannot be carried out because of significant particulate debirs within the CSF, recent surgeries, or infections that were considered substantial enough to impair shunt function or to increase the risk of infection. To clarify the efficacy of VSG shunt for temporary ventricular decompression we analyzed our clinical trial cases. Patients and Methods : VSG shunt was carried out in 8 patient with acute hydrocephalus between February 2000 and June 2000. The causes of acute hydrocephalus were as follows: spontaneous intracerebral hemorrahage and intraventricular hemorrhage in four patients, spontaheous subarachnoid hemorrahge in three patients, tuberculous meningitis in one patient. With these 8 cases we compared pre-operative and post-operative clinical conditions and ventricular size in the brain CT scan. Results : Even though the ventricular size was not changed statistically there was significant clinical improvement between preoperative Glasgow coma scale(GCS)(7.25) and postoperative GCS(9.25). Six patients died as a result of causes unrelated to the VSG shunt. There were no VSG shunt infection. A permanent ventriculoperitoneal shunt surgery was needed in two patients. Conclusion : The VSG shunt is a simple and safe method of treatment for acute hydrocephalus instead of extraventricular drainage in the patients who cannot be underwent a permanent shunt immediately due to some reasons. Even though VSG shunt were free from infection, our preliminary clinical trials suggests that its efficacy seems to be doubtful. Further studies with lots of cases would be needed for its clinical application.
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