yoghurtlyx ：To @Professor Li Xiaoyong
Q: Hi Professor Li, I would like to ask what is the relationship between cerebrospinal fluid shunt infection and abdominal infection? Thank you, Prof. Li Xiaoyong
: It is internationally accepted that cerebrospinal fluid shunt infection is a type of intracranial infection, because the diagnostic criteria in the literature basically follow those of the Centers for Disease Control (CDC) for central nervous system infection or cerebrospinal meningitis. We believe that this is only appropriate for patients with intracranial infections as part of cerebrospinal fluid infection, but in fact cerebrospinal fluid shunt infection also involves infection of tissues at the site where the cerebrospinal fluid is shunted or received, such as the abdominal cavity, thoracic cavity, and blood. Intra-abdominal infections that occur after cerebrospinal fluid shunts have proven to be a very important problem in clinical practice and have not been taken seriously by even a large proportion of neurosurgeons in the past. We recently encountered a patient whose treatment illustrates just how important this issue is. This was a woman in her 30s who had a ventriculoperitoneal shunt for hydrocephalus at the age of 6 and had lived normally for almost 30 years afterwards. However, 2 years ago, a complication of a blocked shunt occurred, and the receiving hospital performed the normal routine surgery to place another shunt, but a few days after this surgery, symptoms of abdominal infection occurred: elevated temperature and abdominal distension. He was given antibiotic treatment in 2 hospitals to preserve the loss of the shunt that would not be removed, and was finally transferred to our hospital after six months of ineffective treatment. However, after a month of treatment, intraventricular adhesions occurred, i.e., isolated temporal horn. After the infection was cured, the ventriculoperitoneal shunt was performed again, and it was found that the abdominal adhesions were more serious and several sites had to be replaced before the shunt was successfully placed in the abdominal cavity. After 8 months of surgery, the abdominal shunt became inoperable again and the patient was again in a coma. This time, the patient came back to the hospital and after treatment, the shunt could not be placed into the abdomen again, then into the chest cavity, and then into the jugular vein, all of which ended in failure. We found from this tragic case that early and correct eradication of the first shunt infection should be the most important way to protect the abdominal cavity. The abdominal cavity is the most important site of cerebrospinal fluid shunt to receive cerebrospinal fluid, and we must try to protect it from severe intra-abdominal adhesions. scriptjava ：A question to @Prof. Li Xiaoyong: Hi Prof. Li, how many types of cerebrospinal fluid disorders are there? Prof. Li Xiaoyong
After nearly 20 years of research, we have solved two major problems in the early stage: the cure rate of hydrocephalus shunt infection can reach about 95%, and the cure rate of simple shunt blockage complication is nearly 100%; then we developed many diseases around these technologies which have gradually increased. Recently, roughly, we have developed more than 40 diseases, and we believe that the number of diseases will continue to increase, so the cerebrospinal fluid department is a promising department. Statistics of the disease types are as follows: 1. basic technology: 1. treatment of complications of cerebrospinal fluid shunt blockage; 2. treatment of complications of cerebrospinal fluid shunt infection; 3. intracranial infection by ventricular puncture and drainage (repeated site change); 4. intracranial infection by lumbar pool drainage (repeated site change) or peri-spinal cord infection; 5. treatment of complications of failed hydrocephalus treatment by hard and soft endoscopy; 6. hydrocephalus intracranial shunt extraction technique and treatment of intracranial hemorrhage due to craniotomy in patients with shunt failure complications; 7, ventricular drainage, treatment of ventricular adhesion complications due to hydrocephalus shunt; 8, complications or syndromes of severe impairment of brain function after hydrocephalus shunt (tremor, xylophobia, muteness, intractable vomiting, Parkinson’s syndrome, extravertebral syndrome, depressive psychosis, cessation of eating movements diplopia, and other subtypes of clinical manifestations); 2. Primary or primary diseases causing cerebrospinal fluid disorders: 1. Idiopathic hydrocephalus and its complications in infants (including congenital hydrocephalus); 2. Meningoencephalitis hydrocephalus in infants (including meningoencephalitis and bacterial or and fungal); 3. Simple subdural extraarachnoid pus in infants (note: pseudo-extracerebral hydrocephalus, and no hydrocephalus); 4. Cerebral hemorrhagic hydrocephalus in infants hydrocephalus; 5, idiopathic hydrocephalus and its complications in children; 6, idiopathic hydrocephalus and its complications in adults (failure of shunts in the abdominal cavity, sagittal sinus, atrium, etc.); 7, normal pressure hydrocephalus; 8, cranial defects and cranial repair (specializing in “pump-not-regulate” repair after hydrocephalic shunts); 9, post-craniotomy cerebral Bulky cerebrospinal fluid disease; 10, traumatic hydrocephalus or cerebrospinal fluid disease (brain bulge, subdural tension fluid); 11, intracranial rupture aneurysm (craniotomy and endovascular embolization) postoperative cerebrospinal fluid disease; 12, intracerebroventricular hemorrhagic cerebrospinal fluid disease; 13, cerebrovascular malformation or cerebral arteriovenous malformation (craniotomy and endovascular embolization) postoperative cerebrospinal fluid disease; 14, septic meningitis hydrocephalus or cerebrospinal fluid disease; 15, simple tuberculous meningitis hydrocephalus or cerebrospinal fluid disease; 16, fungal or cryptococcal meningitis or cerebrospinal fluid infection-related hydrocephalus or cerebrospinal fluid disease; 17, isolated temporal horn hydrocephalus; 18, asymmetric fourth ventricular enlargement hydrocephalus; 19, isolated fourth ventricular enlargement hydrocephalus (fourth ventricular shunt success rate of 95% or more); 20, Spontaneous cerebrospinal fluid leak combined with occult hydrocephalus or cerebrospinal fluid disease; 21, intracranial pneumopericardial complications after hydrocephalic shunt (shunt complications of combined cerebrospinal fluid leak hydrocephalus); 22, cerebellar subm tonsillar herniation hydrocephalus or complications of surgical failure; 23, spinal cavernous hydrocephalus hydrocephalus or complications of surgical failure; 24, (neurosurgery) spinal surgical cerebrospinal fluid disease; 25, (spine orthopedics) spinal fixation surgical cerebrospinal fluid disease; 26, epilepsy craniotomy hydrocephalus or cerebrospinal fluid disease; 27, transnasal transsphenoidal pituitary tumor postoperative intracranial infection or cerebrospinal fluid leakage; 28, transnasal transsphenoidal hollow saddle postoperative severe or fatal cerebrospinal fluid leakage; 29, subscallosal medulloblastoma (preoperative or postoperative) hydrocephalus and its complications in children; 30, fourth ventricle or brainstem tumor postoperative hydrocephalus or surgical complications; 31, postoperative hydrocephalus or cerebrospinal fluid disease after auditory neuroma; 32, complications of hydrocephalus treatment after intracerebroventricular tumor surgery; 33, postoperative hydrocephalus or cerebrospinal fluid disease after trigeminal nerve, facial spasm; 34, postoperative pseudomeningocele or hydrocephalus or cerebrospinal fluid disease after intracranial cholesteatoma; 35, postoperative hydrocephalus or cerebrospinal fluid leakage after craniopharyngioma (after pterygoid plateau abrasion)