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Acta Neurochirurgica

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13.03.2018 | Case Report - Brain Tumors

Intraventricular urokinase to treat a blocked ventriculoperitoneal shunt in a glioblastoma patient with leptomeningeal spread

verfasst von: Peter Y. M. Woo, James T. F. Zhuang, Jason M. K. Ho, Andrew Seto, Hoi-Tung Wong, Kwong-Yau Chan

Erschienen in: Acta Neurochirurgica | Ausgabe 5/2018

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Abstract

Leptomeningeal spread and hydrocephalus are increasingly recognized as late disease complications of glioblastoma with almost a quarter of patients requiring early cerebrospinal fluid shunting. The neurosurgeon is challenged with maintaining shunt patency when tumor disease progression is rapid and adjuvant oncologic therapy has yet to be initiated. We describe our experience in treating a young female with diffuse glioblastoma leptomeningeal spread and communicating hydrocephalus who had several episodes of shunt obstruction due to intraluminal tumor cell-fibrin deposits. Regular intraventricular instillations of urokinase fibrinolytic therapy not only re-established shunt patency but also contributed to the resolution of her hydrocephalus.

Ando S, Moritake K (1989) Communicating hydrocephalus occurring in the postoperative course of glioblastoma multiforme. Nihon Geka Hokan 58:508–515PubMed

Arita N, Taneda M, Hayakawa T (1994) Leptomeningeal dissemination of malignant gliomas. Incidence, diagnosis and outcome. Acta Neurochir 126:84–92CrossRefPubMed

Brinker T, Seifert V, Dietz H (1992) Subacute hydrocephalus after experimental subarachnoid hemorrhage: its prevention by intrathecal fibrinolysis with recombinant tissue plasminogen activator. Neurosurgery 31:306–311 discussion 311-302CrossRefPubMed

Brydon HL, Hayward R, Harkness W, Bayston R (1995) Physical properties of cerebrospinal fluid of relevance to shunt function. 1: the effect of protein upon CSF viscosity. Br J Neurosurg 9:639–644CrossRefPubMed

Brydon HL, Hayward R, Harkness W, Bayston R (1995) Physical properties of cerebrospinal fluid of relevance to shunt function. 2: the effect of protein upon CSF surface tension and contact angle. Br J Neurosurg 9:645–651CrossRefPubMed

Brydon HL, Keir G, Thompson EJ, Bayston R, Hayward R, Harkness W (1998) Protein adsorption to hydrocephalus shunt catheters: CSF protein adsorption. J Neurol Neurosurg Psychiatry 64:643–647CrossRefPubMedPubMedCentral

Castro BA, Imber BS, Chen R, McDermott MW, Aghi MK (2017) Ventriculoperitoneal shunting for glioblastoma: risk factors, indications, and efficacy. Neurosurgery 80:421–430PubMed

Cheatle JT, Bowder AN, Tefft JL, Agrawal SK, Hellbusch LC (2015) Effect of protein concentration on the flow of cerebrospinal fluid through shunt tubing. Neurosurgery 77:972–978CrossRefPubMed

Cinalli G, Sainte-Rose C, Lellouch-Tubiana A, Sebag G, Renier D, Pierre-Kahn A (1995) Hydrocephalus associated with intramedullary low-grade glioma. Illustrative cases and review of the literature. J Neurosurg 83:480–485CrossRefPubMed

10.

Clark AJ, Lamborn KR, Butowski NA, Chang SM, Prados MD, Clarke JL, McDermott MW, Parsa AT, Berger MS, Aghi MK (2012) Neurosurgical management and prognosis of patients with glioblastoma that progresses during bevacizumab treatment. Neurosurgery 70:361–370CrossRefPubMed

11.

Elliott JP, Keles GE, Waite M, Temkin N, Berger MS (1994) Ventricular entry during resection of malignant gliomas: effect on intracranial cerebrospinal fluid tumor dissemination. J Neurosurg 80:834–839CrossRefPubMed

12.

Farb RI, Forghani R, Lee SK, Mikulis DJ, Agid R (2007) The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain. AJNR Am J Neuroradiol 28:1489–1493CrossRefPubMed

13.

Foltz EL, Shurtleff DB (1963) Five-year comparative study of hydrocephalus in children with and without operation (113 cases). J Neurosurg 20:1064–1079. https://doi.org/10.3171/jns.1963.20.12.1064 CrossRefPubMed

14.

Grabb PA, Albright AL, Pang D (1992) Dissemination of supratentorial malignant gliomas via the cerebrospinal fluid in children. Neurosurgery 30:64–71CrossRefPubMed

15.

Inamasu J, Nakamura Y, Saito R, Kuroshima Y, Mayanagi K, Orii M, Ichikizaki K (2003) Postoperative communicating hydrocephalus in patients with supratentorial malignant glioma. Clin Neurol Neurosurg 106:9–15CrossRefPubMed

16.

Lam CH, Cosgrove GR, Drislane FW, Sotrel A (1991) Spinal leptomeningeal metastasis from cerebral glioblastoma. Appearance on magnetic resonance imaging. Surg Neurol 35:377–380CrossRefPubMed

17.

Macdonald DR, Cascino TL, Schold SC Jr, Cairncross JG (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8:1277–1280CrossRefPubMed

18.

Maurice-Williams RS, Lucey JJ (1975) Raised intracranial pressure due to spinal tumours: 3 rare cases with a probable common mechanism. Br J Surg 62:92–95CrossRefPubMed

19.

Muralidharan R (2015) External ventricular drains: management and complications. Surg Neurol Int 6:S271–S274CrossRefPubMedPubMedCentral

20.

Noh JH, Lee MH, Kim WS, Lim DH, Kim ST, Kong DS, Nam DH, Lee JI, Seol HJ (2015) Optimal treatment of leptomeningeal spread in glioblastoma: analysis of risk factors and outcome. Acta Neurochir 157:569–576CrossRefPubMed

21.

Occhipinti E, Carapella C (1982) Shunt failure in hydrocephalus with high protein fluid. Monog Neural Sci 8:220–222

22.

Onda K, Tanaka R, Takahashi H, Takeda N, Ikuta F (1989) Cerebral glioblastoma with cerebrospinal fluid dissemination: a clinicopathological study of 14 cases examined by complete autopsy. Neurosurgery 25:533–540CrossRefPubMed

23.

Shooman D, Vajramani GV, Davidson J, Sparrow OC (2010) Use of intrathecal urokinase in repeated shunt and external ventricular drain blockage from high CSF protein due to an optic pathway glioma. Childs Nerv Syst 26:607–611CrossRefPubMed

24.

Staykov D, Kuramatsu JB, Bardutzky J, Volbers B, Gerner ST, Kloska SP, Doerfler A, Schwab S, Huttner HB (2017) Efficacy and safety of combined intraventricular fibrinolysis with lumbar drainage for prevention of permanent shunt dependency after intracerebral hemorrhage with severe ventricular involvement: a randomized trial and individual patient data meta-analysis. Ann Neurol 81:93–103CrossRefPubMed

25.

Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, Belanger K, Brandes AA, Marosi C, Bogdahn U, Curschmann J, Janzer RC, Ludwin SK, Gorlia T, Allgeier A, Lacombe D, Cairncross JG, Eisenhauer E, Mirimanoff RO, European Organisation for R, Treatment of Cancer Brain T, Radiotherapy G, National Cancer Institute of Canada Clinical Trials G (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996

Titel: Intraventricular urokinase to treat a blocked ventriculoperitoneal shunt in a glioblastoma patient with leptomeningeal spread
verfasst von: Peter Y. M. Woo
James T. F. Zhuang
Jason M. K. Ho
Andrew Seto
Hoi-Tung Wong
Kwong-Yau Chan
Publikationsdatum: 13.03.2018
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 5/2018
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-018-3509-9

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