Daniel H Fulkerson1, Joel C Boaz, Thomas G Luerssen. 1. Pediatric Neurosurgery Service, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, 702 Barnhill Drive, Room 1134, Indianapolis, IN 46202, USA. dfulkers@iupui.edu
Abstract
OBJECTIVE: The authors present three cases of children with shunted hydrocephalus and intrathecal delivery of baclofen via an implanted pump. Each case illustrates a potential interaction of these devices. MATERIALS AND METHODS: A review of the pertinent charts, operative notes, and discharge summaries was performed, along with examination of the pertinent literature. CONCLUSION: The first case illustrates that a change in the pharmacology or effect of intrathecal baclofen may be caused by a failure of a shunt affecting cerebrospinal fluid clearance. The second case illustrates that patients can have ventricular changes with any procedure that accesses the thecal space, even with a functioning shunt. The third case illustrates that ensuring that a patient's shunt is functional before implantation of a baclofen pump is imperative. As the potential pool of patients with both shunted hydrocephalus and need for intrathecal baclofen grows, clinicians should be aware of potential serious interactions.
OBJECTIVE: The authors present three cases of children with shunted hydrocephalus and intrathecal delivery of baclofen via an implanted pump. Each case illustrates a potential interaction of these devices. MATERIALS AND METHODS: A review of the pertinent charts, operative notes, and discharge summaries was performed, along with examination of the pertinent literature. CONCLUSION: The first case illustrates that a change in the pharmacology or effect of intrathecal baclofen may be caused by a failure of a shunt affecting cerebrospinal fluid clearance. The second case illustrates that patients can have ventricular changes with any procedure that accesses the thecal space, even with a functioning shunt. The third case illustrates that ensuring that a patient's shunt is functional before implantation of a baclofen pump is imperative. As the potential pool of patients with both shunted hydrocephalus and need for intrathecal baclofen grows, clinicians should be aware of potential serious interactions.
Authors: R Gilmartin; D Bruce; B B Storrs; R Abbott; L Krach; J Ward; K Bloom; W H Brooks; D L Johnson; J R Madsen; J F McLaughlin; J Nadell Journal: J Child Neurol Date: 2000-02 Impact factor: 1.987
Authors: Elke Pucks-Faes; Judith Dobesberger; Lucas-Michael Halbmayer; Gabriel Hitzenberger; Heinrich Matzak; Leopold Saltuari Journal: Arch Rehabil Res Clin Transl Date: 2020-09-16