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does dehydration effect the intercranial pressure & effect how a vp shunt works


Posted by Lizzie

 
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Perhaps so.  I just saw the following research abstract at the Journal of Neurosurgery website (thejns.org):

Transient ventriculomegaly in a child presenting with hypernatremia - Case Report

  • John Fahrbach, M.D. and 
  • Curtis J. Rozzelle, M.D.
  • Department of Neurosurgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, New York
Abbreviations used in this paper: CT = computerized tomography; DI = diabetes insipidus; ICF = intracellular fluid; ICP = intracranial pressure; VP = ventriculoperitoneal.
Address reprint requests to: Curtis J. Rozzelle, M.D., Pediatric Neurosurgery, Women and Children’s Hospital of Buffalo, 219 Bryant Street, Buffalo, New York 14222. email: CRozzelle (at) kaleida_health.org.  
Abstract
The authors present the case of a 3-year-old girl with a history of myelomeningocele repair, ventriculoperitoneal (VP) shunt placement for hydrocephalus, and shaken baby syndrome who presented in a hypernatremic state as a result of dehydration. At the time of presentation, the patient had experienced a 1-week-long history of diarrhea associated with antibiotic agents used to treat a coexisting pyelonephritis. On admission, the patient exhibited signs and symptoms of dehydration and was discovered to have profound hypernatremia with a serum sodium level of 180 mmol/L. A computerized tomography (CT) scan of the head revealed ventricular enlargement compared with previous imaging findings. A shunt tap revealed intracranial hypotension with good proximal flow. The child was treated for her hyper-natremic state, and her neurological condition returned to baseline level. Subsequent CT scans of the head demonstrated a return of the ventricular system to its premorbid size.

On the basis of the initial radiographic presentation and subsequent evaluation, the authors hypothesize that the ventricular enlargement was a result of hypernatremia. The signs and symptoms were similar to those found in patients with a VP shunt obstruction; however, a shunt tap revealed intracranial hypotension and excellent proximal flow. To the authors’ knowledge, there has not been a radiographically documented case of reversible ventricular enlargement associated with hypernatremia.

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