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Kravchuk A.D.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Latyshev Ia.A.

FGBNU "NII neĭrokhirurgii im. akad. N.N. Burdenko", Moskva

Zaĭtsev O.S.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Danilov G.V.

N.N. Burdenko National Medical Research Center of Neurosurgery under Ministry of Health of the Russi, 125047, Moscow, Russia

Likhterman L.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Gavrilov A.G.

N.N. Burdenko Institute of Neurosurgery, Moscow, Russia

Zakharova N.E.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Kormilitsyna A.N.

Burdenko Neurosurgical Institute, Moscow, Russia

Okhlopkov V.A.

GBOU "Omskaia gosudarstvennaia meditsinskaia akademiia" Ministerstva zdravookhraneniia Rossiĭskoĭ Federatsii

Potapov A.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Aleksandrova E.V.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

CSF shunting surgery in patients with post-traumatic hydrocephalus in the vegetative status and minimally conscious state: analysis of its efficacy and safety

Authors:

Kravchuk A.D., Latyshev Ia.A., Zaĭtsev O.S., Danilov G.V., Likhterman L.B., Gavrilov A.G., Zakharova N.E., Kormilitsyna A.N., Okhlopkov V.A., Potapov A.A., Aleksandrova E.V.

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Journal: Burdenko's Journal of Neurosurgery. 2019;83(1): 17‑28

DOI: 10.17116/neiro20198301117

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Table of contents

CSF SHUNTING SURGERY IN PATIENTS WITH POST-TRAUMATIC HYDROCEPHALUS IN THE VEGETATIVE STATUS AND MINIMALLY CONSCIOUS STATE: ANALYSIS OF ITS EFFICACY AND SAFETY
CSF SHUNTING SURGERY IN PATIENTS WITH POST-TRAUMATIC HYDROCEPHALUS IN THE VEGETATIVE STATUS AND MINIMALLY CONSCIOUS STATE: ANALYSIS OF ITS EFFICACY AND SAFETY

To cite this article:

Kravchuk AD, Latyshev IaA, Zaĭtsev OS, et al. CSF shunting surgery in patients with post-traumatic hydrocephalus in the vegetative status and minimally conscious state: analysis of its efficacy and safety. Burdenko's Journal of Neurosurgery. 2019;83(1):17‑28. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20198301117

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
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Abstract:

The development of post-traumatic hydrocephalus (PTH) after severe traumatic brain injury can cause, in some cases, severe impairment of consciousness and prevent rehabilitation of patients. The influence of cerebrospinal fluid (CSF) circulation disorders on processes of consciousness recovery is a fundamental problem that requires in-depth research. The issues of differential diagnosis, results of surgical treatment of PTH, and its complications in patients in the vegetative status (VS) and minimally conscious state (MCS) remain poorly covered. Material and methods. We performed a retrospective analysis of the long-term outcomes of surgical treatment in 82 PTH patients in the VS (38 cases) and MCS (44 cases). Results. A significant clinical improvement occurred in 60.6% of VS patients and in 65.9% of MCS patients. The rate of shunt infection was high and amounted to 21.05% in the group of VS patients and 20.4% in the group of MCS patients. The rate of shunt system dysfunction was 26.05% in the first group and 20.4% in the second group. Postoperative mortality (associated directly with treatment complications) was 3.6%. Total mortality was 10.9%. Discussion. The positive effect of shunting surgery in patients with gross impairment of consciousness was associated with transition to higher levels of consciousness. The high rate of complications, especially infections, was due to a serious condition of patients and comorbidities, in particular chronic infection foci. Shunt system dysfunction was not a factor of the adverse outcome of surgical treatment because rarely led to irreversible consequences, but required repeated surgery. Mortality after shunting surgery was significantly higher in patients with gross impairment of consciousness than in other groups of patients. We found a correlation between deaths in VS patients and shunt infection in the postoperative period. Conclusion. CSF shunting surgery is an important step in surgical rehabilitation of PTH patients. To assess the contribution of various risk factors to the development of shunt infection and to develop measures reducing its rate, further prospective studies are needed.

Keywords:

traumatic brain injury consequences
post-traumatic hydrocephalus
shunting surgery
consciousness recovery
vegetative status
minimally conscious state
shunt infection

Authors:

Kravchuk A.D.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Latyshev Ia.A.

FGBNU "NII neĭrokhirurgii im. akad. N.N. Burdenko", Moskva

Zaĭtsev O.S.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Danilov G.V.

N.N. Burdenko National Medical Research Center of Neurosurgery under Ministry of Health of the Russi, 125047, Moscow, Russia

Likhterman L.B.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Gavrilov A.G.

N.N. Burdenko Institute of Neurosurgery, Moscow, Russia

Zakharova N.E.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Kormilitsyna A.N.

Burdenko Neurosurgical Institute, Moscow, Russia

Okhlopkov V.A.

GBOU "Omskaia gosudarstvennaia meditsinskaia akademiia" Ministerstva zdravookhraneniia Rossiĭskoĭ Federatsii

Potapov A.A.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Aleksandrova E.V.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

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