Shunt Revision Overview in Patients with Hydrocephalus

Abstract

Background: Hydrocephalus is a notorious neurosurgical disease thatcarries the adage “once a shunt always a shunt.” Most patients withhydrocephalus are treated with ventriculo‐peritoneal (VP) shunt placement;however, malfunction is common and is usually caused by mechanicalfailure.Aim: To evaluate the patients who were in need for shunt revision, analyzingthem according to their age, sex, and causes of their hydrocephalus, andinvestigating the etiological causes for their revisions.Patients and Methods: In a retrospective study, the records of 90 patientswho underwent their shunt revision in the Neurosurgical hospital andneurosurgical departments of AL‐Kadhmia teaching hospital and thehospital of surgical specialties between January 2000 till June 2002 wereanalyzed peri‐operativelyResults: It was revealed that most of the revised patients were children(their age≤10). The majority of them were shunted at first due to congenitalhydrocephalus and acquired hydrocephalus respectively. Regarding thefrequency of revision in these patients the majority were revised once andfew of them were revised for more than one time. Peri‐operatively clinicalstatus of shunt function was determined which showed upper end block in27.8%, post‐operative meningitis in 13.3%. Yet, lower end block was found in10% of the cases.Conclusion: Shunt failure is still far too common especially in pediatric agegroups. Upper end block together with surgical errors and suboptimaltechniques plays a significant role in shunt revision.