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Case report
peer-reviewed

Real-Time Fluoroscopic and C-Arm Computed Tomography Evaluation of Ommaya Reservoir Integrity



Abstract

We describe a case of a 24-year-old patient with relapsed acute myelogenous leukemia involving the central nervous system. After placement of an Ommaya reservoir for intrathecal chemotherapy administration, the patient developed progressive headache, nausea, and drowsiness and was found to have an enlarging subdural collection underlying the Ommaya. To exclude leakage of the Ommaya system into the subdural space, real-time fluoroscopic and C-arm computed tomographic evaluation of the Ommaya reservoir was performed after iodinated contrast injection into the reservoir. This novel technique demonstrated complete integrity of the Ommaya reservoir without evidence of blockage or leakage of the system. The patient underwent uncomplicated evacuation of the subdural collection without replacement of the Ommaya reservoir and made an excellent recovery. This technique for real-time interrogation of the Ommaya reservoir may have additional utility in the evaluation for Ommaya reservoir dysfunction.



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Case report
peer-reviewed

Real-Time Fluoroscopic and C-Arm Computed Tomography Evaluation of Ommaya Reservoir Integrity


Author Information

Adrienne M. Moraff

Department of Neurosurgery, Stanford University School of Medicine

Melanie Hayden Gephart

Department of Neurosurgery, Stanford University School of Medicine

Larry M. Shuer

Stanford University School of Medicine

Stanford University School of Medicine

Jeremy J. Heit Corresponding Author

Department of Radiology, Stanford University School of Medicine


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Real-Time Fluoroscopic and C-Arm Computed Tomography Evaluation of Ommaya Reservoir Integrity


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Case report
peer-reviewed

Real-Time Fluoroscopic and C-Arm Computed Tomography Evaluation of Ommaya Reservoir Integrity

  • Author Information
    Adrienne M. Moraff

    Department of Neurosurgery, Stanford University School of Medicine

    Melanie Hayden Gephart

    Department of Neurosurgery, Stanford University School of Medicine

    Larry M. Shuer

    Stanford University School of Medicine

    Stanford University School of Medicine

    Jeremy J. Heit Corresponding Author

    Department of Radiology, Stanford University School of Medicine


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: March 15, 2017

    DOI

    10.7759/cureus.1097

    Cite this article as:

    Moraff A M, Hayden gephart M, Shuer L M, et al. (March 15, 2017) Real-Time Fluoroscopic and C-Arm Computed Tomography Evaluation of Ommaya Reservoir Integrity. Cureus 9(3): e1097. doi:10.7759/cureus.1097

    Publication history

    Received by Cureus: February 26, 2017
    Peer review began: March 08, 2017
    Peer review concluded: March 11, 2017
    Published: March 15, 2017

    Copyright

    © Copyright 2017
    Moraff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We describe a case of a 24-year-old patient with relapsed acute myelogenous leukemia involving the central nervous system. After placement of an Ommaya reservoir for intrathecal chemotherapy administration, the patient developed progressive headache, nausea, and drowsiness and was found to have an enlarging subdural collection underlying the Ommaya. To exclude leakage of the Ommaya system into the subdural space, real-time fluoroscopic and C-arm computed tomographic evaluation of the Ommaya reservoir was performed after iodinated contrast injection into the reservoir. This novel technique demonstrated complete integrity of the Ommaya reservoir without evidence of blockage or leakage of the system. The patient underwent uncomplicated evacuation of the subdural collection without replacement of the Ommaya reservoir and made an excellent recovery. This technique for real-time interrogation of the Ommaya reservoir may have additional utility in the evaluation for Ommaya reservoir dysfunction.



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Create a free account to continue reading this article.

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Adrienne M. Moraff

Department of Neurosurgery, Stanford University School of Medicine

Melanie Hayden Gephart, M.D.

Department of Neurosurgery, Stanford University School of Medicine

Larry M. Shuer, M.D.

Stanford University School of Medicine

Jeremy J. Heit

Department of Radiology, Stanford University School of Medicine

For correspondence:
jheit@stanford.edu

Adrienne M. Moraff

Department of Neurosurgery, Stanford University School of Medicine

Melanie Hayden Gephart, M.D.

Department of Neurosurgery, Stanford University School of Medicine

Larry M. Shuer, M.D.

Stanford University School of Medicine

Jeremy J. Heit

Department of Radiology, Stanford University School of Medicine

For correspondence:
jheit@stanford.edu