Percutaneously inserted ventriculoureteral shunt as a salvage treatment in pediatric hydrocephalus: a technical note

Abstract

Abstract Background: Hydrocephalus is a challenge for pediatric neurosurgeons. When the abdominal cavity and heart fail as diversion sites for cerebrospinal fluid (CSF), many of the otherwise used alternative diversion sites are not feasible due to the smaller physical body size of children and infants. Using the urinary system as a site of diversion has been described in adults primarily.Objective: To describe a minimally invasive procedure to percutaneously access the ureter for placement of a distal catheter in the treatment of pediatric hydrocephalusMethods: A percutaneous ultrasound-assisted technique, was used to access the renal pelvis for catheter placement into the distal ureter.Results: Fifteen months after the surgery the child has a stable neurological condition and adequately managed hydrocephalus.Conclusion: The urinary tract should be considered a viable option for CSF diversion in complex pediatric hydrocephalus. A multidisciplinary approach consisting of interventional radiologists, urologists and neurosurgeons should be involved in the evaluation of potential candidates.