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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Congenital hydrocephalus and ventriculoperitoneal shunts: influence of etiology and programmable shunts on revisions

Christina Notarianni1, Prasad Vannemreddy, Gloria Caldito

  • 1Department of Neurosurgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana, USA.

Journal of Neurosurgery. Pediatrics
|December 3, 2009
PubMed

Insights

Pediatric hydrocephalus treatment shows posthemorrhagic and craniospinal dysraphism etiologies require earlier shunt revisions. Programmable shunts did not significantly reduce failure rates or revision numbers in this study.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Biomedical Engineering

Background:

  • Hydrocephalus is a common neurosurgical condition in children.
  • The adage "once a shunt always a shunt" highlights the challenge of shunt dependence.

Purpose of the Study:

  • To review treatment outcomes for pediatric hydrocephalus.
  • To identify risk factors for shunt failure and revision.

Main Methods:

  • Retrospective review of 253 pediatric patients undergoing ventriculoperitoneal shunt surgery over 14 years.
  • Analysis of variables including age, shunt type (programmable vs. others), infection, obstruction, and hydrocephalus etiology.
  • Statistical analysis using multiple regression and Kaplan-Meier survival analysis to assess revision-free rates.

Main Results:

  • 78% of patients required shunt revision surgeries.
  • Posthemorrhagic and craniospinal dysraphism hydrocephalus showed significantly poorer 5-year revision-free survival rates compared to congenital or other causes.
  • Programmable shunts offered no significant advantage in reducing failure rates or revision frequency.

Conclusions:

  • Hydrocephalus secondary to posthemorrhagic and craniosynostosis dysraphism necessitates earlier shunt revisions.
  • Programmable shunt systems did not demonstrate improved outcomes in terms of shunt failure or revision rates.
Abstract

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