Progressive Functional Underdrainage in Cerebrospinal Fluid Shunt-Dependent Women During Pregnancy: Case Report and Review of the Literature

World Neurosurg. 2018 Jan:109:372-376. doi: 10.1016/j.wneu.2017.09.108. Epub 2017 Oct 14.

Abstract

Background: Since the 1950s cerebrospinal fluid (CSF) shunt dependency has no longer been a contradiction to normal life, including sexuality and pregnancy in women, because of advances in the understanding of hydrocephalus and shunt technology. Although pregnancy in shunt-dependent women is rare, it causes uncertainty among treating physicians.

Case description: We report the case of a 34-year-old pregnant woman with a ventriculoperitoneal shunt. Throughout her pregnancy she experienced progressive symptoms of CSF underdrainage without any signs of other pregnancy-related complications. After the delivery of a healthy infant, shunt resistance had to be readjusted to prepregnancy levels. A comprehensive review of the literature reports in English, listed in PubMed, is provided.

Conclusions: Conservative treatment of pregnancy-related functional underdrainage by consecutive valve pressure adjustment is possible, easy, and safe.

Keywords: Hydrocephalus; Intraabdominal pressure; Intracranial pressure; Pregnancy; Ventriculoperitoneal shunt.

Publication types

  • Review

MeSH terms

  • Adult
  • Cerebrospinal Fluid Pressure / physiology
  • Equipment Failure*
  • Female
  • Humans
  • Hydrocephalus / congenital
  • Hydrocephalus / surgery*
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications / cerebrospinal fluid*
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / therapy
  • Pregnancy Trimester, Second
  • Ventriculoperitoneal Shunt*