The changing panorama of shunt complications. Twenty-five years' experience

The distribution of shunt complications is analyzed in a series of 226 children and infants out of a total of 978 shunt operations performed between the years 1965 and 1989. The rate of shunt infections and obstructions has decreased significantly during the last ten years while the rate of CSF overdrainage complications has increased. A policy of active, elective shunt revisions has led to a reduction in the total rate of shunt revisions required. As only minor changes in the shunts available and used have taken place during the period converted, it is concluded that the main reason for the changing panorama of shunt revisions lies in improved neuroimaging and a better knowledge of complying with shunt complications.