EEG Correlates of Spikes in Intracranial Pressure Caused by Transient Ventriculoperitoneal Shunt Malfunction.
Paul WangAllison DonaNikita KhetarpalStephanie ReederJetter RobertsonSima PatelPublished in: Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society (2023)
A 30-year-old man with recurrent headaches and seizure-like activity and a 26-year-old woman with worsening headaches were admitted to the hospital. Both had ventriculoperitoneal shunts and history of several shunt revisions for congenital hydrocephalus. The ventricle size visualized on computed tomography scans was unremarkable, and shunt series were negative in both cases. Both patients began to present with brief periods of unresponsiveness, and video electroencephalography at that time showed periods of diffuse delta slowing. Lumbar punctures revealed increased opening pressures. Despite normal imaging and shunt series, both patients ultimately had increased intracranial pressure caused by shunt malfunction. This series demonstrates the difficulty of diagnosing potential transient increases in intracranial pressure based on standard-of-care diagnostics/examination and the potentially critical role for EEG in the identification of shunt malfunction.
Keyphrases
- pulmonary artery
- computed tomography
- end stage renal disease
- ejection fraction
- newly diagnosed
- healthcare
- chronic kidney disease
- pulmonary hypertension
- coronary artery
- peritoneal dialysis
- heart failure
- functional connectivity
- minimally invasive
- working memory
- emergency department
- resting state
- low grade
- optic nerve
- high grade
- patient reported outcomes
- brain injury
- chronic pain
- mass spectrometry
- magnetic resonance
- single cell