A&P Basics BIOL 2404 Case Study: Nervous System Dr. Weis
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Previous History:
A 64 year old male was presented to the neurology service on July 16. Physical exam findings demonstrated progressive ataxia, increasing mental deficits, and cognitive deterioration. CT scan showed moderate hydrocephalus. The patient was a former professional boxer and had experienced several blows to the head resulting in several minor head injuries and two concussions.
On recent recheck admission, he underwent an MRI which confirmed the CT findings.
No cerebral aneurysm , tumor, subarachnoid hemorrhage or meningitis were found.
Surgical correction was recommended and the patient was referred to the surgery center.
The rest of the physical exam, blood work and urinalysis were within normal limits.
Proposed Operation: Right Ventriculoperitoneal Shunt
Preoperative Diagnosis:
Procedure:
The right posterior auricular region, anterior neck, chest and upper abdomen were prepped and draped in the usual manner. A midsagittal incision was made in the subxiphoid region. The peritoneum was identified and brought through the linea alba.
A crescent shaped incision was made behind the right ear and a hole was created using a trephine. The right ventricle was accessed and clear CSF was obtained for analysis.
Ventriculoperitoneal tubing was passed between the two incisions and a medium pressure valve was inserted at the proximal end. The system was connected and internalized. Incisions were closed using Dermalon. No surgical complications. The instrument and sponge count are correct.
Postoperative Diagnosis:
Postoperative course: No complications. Shunt working properly and no evidence of infection or adhesions. Follow up exam and repeat CT scan have been planned.