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Updated: Mar 22, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Experience of ventriculo-peritoneal shunt insertion in late presenting congenital hydrocephalus
Zahid Hussain1, Abdul Ghaffar1, Shahzad Ahmed Qasmi1
1Combined Military Hospital, Rawalpindi Cantonment, Pakistan.
Insights
Ventriculo-peritoneal shunts in neglected paediatric hydrocephalus showed high complication rates, including infection and wound issues. Careful patient selection and timely intervention are crucial for improving surgical outcomes in these infants.
Area of Science:
- Neurosurgery
- Paediatric Surgery
- Medical Technology
Background:
- Neglected hydrocephalus in infants presents significant surgical challenges.
- Ventriculo-peritoneal shunting is a common intervention for paediatric hydrocephalus.
- Outcomes in late-presenting, severe cases require careful evaluation.
Purpose of the Study:
- To assess the results of ventriculo-peritoneal shunt insertion in infants with neglected hydrocephalus.
- To identify complications and mortality associated with this procedure in a specific cohort.
- To explore factors influencing surgical outcomes in this high-risk group.
Main Methods:
- A quasi-experimental study involving 30 infants with congenital hydrocephalus (fronto-occipital circumference >98th percentile).
- Pre-operative assessment included clinical evaluation, laboratory tests, and CT scans.
- Post-shunt insertion outcomes were monitored, with data analyzed using SPSS 17.
Main Results:
- The study included 30 infants (60% male), with a mean age of 7.73 months.
- High rates of complications were observed: 40% cerebrospinal fluid infection, 23.3% abdominal wound issues.
- 60% of shunts required removal and re-insertion; in-hospital mortality was 43.3%.
Conclusions:
- Ventriculo-peritoneal shunting in neglected paediatric hydrocephalus is associated with substantial risks.
- Significant correlation found between fronto-occipital circumference and mortality (p=0.001).
- Timely presentation and meticulous case selection are vital to improve surgical outcomes.
Objective:
To evaluate the outcomes of insertion of ventriculo-peritoneal shunts in paediatric neglected hydrocephalus.
Methods:
The quasi-experimental study was conducted at the Combined Military Hospital, Rawalpindi, from January 2012 to June 2014, and comprised infants of both genders who presented late with congenital hydrocephalus, having fronto-occipital circumference more than 98 percentile of matched age group. Pre-operative assessment was based upon detailed history, clinical examination, laboratory investigations and computed tomography scan of head. After insertion of ventriculo-peritoneal shunt, patients were followed up for outcomes. Data was analysed using SPSS 17.
Results:
Of the 30 infants, 12(40%) were girls and 18(60%) were boys. Overall mean age was 7.73±1.41 months (range: 5-10 months). Mean fronto-occipital circumference was 54.30±3.08. Cerebrospinal fluid infection was documented in 12(40%). Abdominal wound complications were observed in 7(23.3%) infants. Ventriculo-peritoneal shunt was removed in 18(60%) and eventually replaced in 18(60%). In-hospital mortality on account of complications was encountered in 13(43.3%). Correlation of fronto-occipital circumference to mortality was significant (p=0.001).
Conclusions:
To shunt or not to shunt remains a dilemma for poor-risk infants, but timely reporting of infants with hydrocephalus, proper case selection may improve the outcome of surgical intervention.
