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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Risk factors for recurrent shunt infections in children

Adem Yilmaz1, Ahmet Murat Musluman, Nazan Dalgic

  • 1Department of Neurosurgery, Sisli Etfal Training and Research Hospital, Halaskargazi Street, Istanbul 34100, Turkey. ademyilmaz70@yahoo.com

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|April 21, 2012
PubMed

Insights

To reduce recurrent shunt infections, doctors should fully remove the shunt system and insert a new external ventricular drainage (EVD) catheter. Externalizing the existing catheter increases the risk of these serious cerebrospinal fluid (CSF) infections.

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Diseases

Background:

  • Shunt-related cerebrospinal fluid (CSF) infections are a significant complication in hydrocephalus management.
  • Initial shunt infections (ISI) require prompt treatment to prevent further complications.

Purpose of the Study:

  • To analyze risk factors for recurrent shunt infections (RSI) following treatment for ISI.
  • To compare the efficacy of different management strategies for ISI in preventing RSI.

Main Methods:

  • Retrospective analysis of 58 children treated for ISI.
  • Treatment strategies included shunt removal with external ventricular drainage (EVD) catheter insertion or externalization of the existing ventricular catheter.
  • Comparison of RSI rates between the two treatment groups.

Main Results:

  • Fifteen children (25.9%) developed recurrent shunt infections (RSI).
  • A statistically significant increase in RSI was observed in children treated by externalizing the existing ventricular catheter compared to those undergoing total shunt removal and EVD insertion.
  • 9 out of 44 (20.5%) children treated with shunt removal and EVD insertion developed RSI, while 6 out of 14 (42.9%) children treated with externalization developed RSI.

Conclusions:

  • Total shunt removal and insertion of a new EVD catheter is the preferred strategy to minimize the risk of recurrent shunt infections.
  • Externalization of the existing ventricular catheter is associated with a higher risk of RSI and should be avoided when possible.

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