Management of hydrocephalus using the Chabbra shunt

Over a two-year period, 223 patients with hydrocephalus were admitted to the wards of Queen Elizabeth Central Hospital, Blantyre. Of these 223 patients, 111 were male and 112 were female. All children of less than 18 months underwent ultrasonography to confirm the diagnosis of hydrocephalus, and 22 older patients had a CT scan. The commonest causes of hydrocephalus were meningitis and congenital hydrocephalus. 201 had ventricular aspiration to assess suitability for shunting and in 157 patients, the cerebrospinal fluid (CSF) was clear and these patients were considered suitable for insertion of a ventriculo-peritoneal (VP) shunt. The outcome was satisfactory in 73% of the patients with 10 patients lost to follow-up. There were 12 (7.6%) patients with shunt infections, 6 (3.8%) patients had peritoneal shunt blockage and 2 (1.3%) had over-drainage. There were 2 cases of shunt prolapsing through the anus. Twenty patients died (12.7%): one had inflammation along the shunt tract, one had valve malfunction and one had the valve exposed on the scalp.