GUSTAVO SOUSA NOLETO
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- Monoblock external ventricular drainage system in the treatment of patients with acute hydrocephalus: A pilot study(2014) ANDRADE, Almir Ferreira de; PAIVA, Wellingson Silva; NEVILLE, Iuri Santana; NOLETO, Gustavo Sousa; ALVES JUNIOR, Aderaldo; SANDON, Luiz Henrique Dias; BOR-SENG-SHU, Edson; AMORIM, Robson Luis; TEIXEIRA, Manoel JacobsenBackground: Infection is a major complication in patients undergoing external ventricular drainage (EVD). Our study aimed to evaluate the incidence of infection in a series with the monoblock EVD system. Material/Methods: 46 patients treated with EVD at our emergency department were analyzed prospectively to research the incidence of infections with a new EVD system. Results: The average rate of infection was 8.7%. When we stratified the patients according to the exclusive use of EVD without craniotomies, we identified a reduction in the overall incidence of ventriculitis from 8.7% to 2.3%. Age, etiology, and the presence of ventricular bleeding were not statistically significant risk factors. Conclusions: Despite the small sample examined in this study, we believe that the monoblock system is a simple, inexpensive device that reduces accidental disconnection of the system.
article 4 Citação(ões) na Scopus Giant acute epidural hematoma after ventriculoperitoneal shunt: a case report and literature review(2014) NOLETO, Gustavo; NEVILLE, Iuri Santana; TAVARES, Wagner Malago; SAAD, Felippe; PINTO, Fernando Campos; TEIXEIRA, Manoel Jacobsen; PAIVA, Wellingson SilvaCerebrospinal fluid over-drainage is a common complication of ventriculoperitoneal devices. In terms of haemorrhage, subdural haematomas are usually more frequent lesions than epidural hematomas, which, more rarely, may also be seen after ventricular shunt procedures and may lead to rapid neurological decline and even death unless a surgical procedure can be promptly performed. This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosis of normal pressure hydrocephalus submitted to a ventriculoperitoneal shunt with a high fixed pressure valve. After discharge, on the second day after the procedure, he presented with headache and impaired level of consciousness. At hospital admission he was in a coma and anisochoric. Underwent endotracheal intubation and a head CT, showed epidural hematoma. We performed emergency craniotomy to drain the hematoma, the patient died in the operating room despite resuscitation attempts. In conclusion, prompt diagnosis and emergency craniotomy is recommended in these cases. We must be aware of this possible evolution and maintain high suspicion besides a longer in-hospital observation after these procedures.