A study of VP shunt in management of hydrocephalus

Sudhir Singh Pal; Saurabh Dubey

doi:10.18203/2349-2902.isj20171623

Authors

Sudhir Singh Pal Department of Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Saurabh Dubey Department of Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20171623

Keywords:

Hydrocephalus, Shunt complications, VP shunt

Abstract

Background: Hydrocephalus a neurological disorder common in both children and adults. VP shunt placement is considered the mainstay of management. The aim was to study complications of VP Shunt and factors influencing shunt malfunction and prognosis.

Methods: This study was conducted in the Department of Surgery, Gandhi Medical College Bhopal, Madhya Pradesh, India between January 2013 to August 2016 and included all patients of hydrocephalus who underwent VP shunt surgery. We performed a retrospective and prospective data review which was subjected to statistical analysis, frequency determination, determination of mean and standard deviation, Pearson’s Chi-square test for studying associations between variables.

Results: A total of 198 patients were studied. The predominant etiologies being congenital hydrocephalus, aqueduct stenosis, spina bifida/MMC, intracranial space occupying lesions and tuberculous meningitis. The incidence of overall shunt complications was 28.8%, incidence of shunt revision was 21.2%, shunt blockade 7.6%), shunt migration 5.05%, shunt infection 4.5%, and shunt malfunction due to other causes 8.6%. The mortality rate was 20.2%. Factors associated with increased shunt complications included infective etiology of the hydrocephalus and CSF culture positivity in preoperative period.

Conclusions: Infective and traumatic causes of hydrocephalus are more likely to be associated with complications like infection and obstruction. Shunt migration is seen in paediatric patients.

Metrics

Metrics Loading ...

Author Biography

Sudhir Singh Pal, Department of Surgery, Gandhi Medical College, Bhopal, Madhya Pradesh, India

Associate Professor

Department of Surgery

References

Rekate HL. A contemporary definition and classification of hydrocephalus. Semin Pediatr Neurol. 2009;16(1):9-15.

Lacy M, Oliveira M, Austria E, Frim MD. Neurocognitive outcome after endoscopic third ventriculocisterostomy in patients with obstructive hydrocephalus. J Int Neuropsychol Soc. 2009;15(3):394-8.

Woodworth GF, McGirt MJ, Williams MA, Rigamonti D. Cerebrospinal fluid drainage and dynamics in the diagnosis of normal pressure hydrocephalus. Neurosurgery. 2009;64(5):919-25; discussion: 925-6.

Akai K, Uchigasaki S, Tanaka U, Komatsu A. Normal pressure hydrocephalus. Pathol Int. 1987;37(1):97-110.

Graff-Radford NR. Normal pressure hydrocephalus. Neurol Clin. 2007;25(3):809-32.

Hakim CA, Hakim R, Hakim S. Normal-pressure hydrocephalus. Neurosurgery Clinics of North America. 2001;12(4):761.

Swallow DM, Fellner N, Varsos GV, Czosnyka M, Smielewski P, Pickard JD, Czosnyka Z. Repeatability of cerebrospinal fluid constant rate infusion study. Acta Neurologica Scandinavica. 2014;130(2):131-8.

Reddy GK, Bollam P, Shi R, Guthikonda B, Nanda A. Management of adult hydrocephalus with ventriculoperitoneal shunts: Long-term single-institution experience. Neurosurgery. 2011;69:774-81.

Khan F, Rehman A, Shamim MS, Bari ME. Factors affecting ventriculoperitoneal shunt survival in adult patients. Surg Neurol Int. 2015;6:25.

Ahmed A, Sandlas G, Kothari P, Sarda D, Gupta A, Karkera P, Joshi P. Outcome analysis of shunt surgery in hydrocephalus. J Indian Assoc Pediatr Surg. 2009;14(3):98-101.