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Ventriculopleural shunts for hydrocephalus: a useful alternative
R F Jones1, B G Currie, B C Kwok
1Prince of Wales Children's Hospital, Randwick, New South Wales, Australia.
Neurosurgery
|December 1, 1988
Summary
Ventriculopleural shunts showed high complication rates, particularly symptomatic pleural effusion, necessitating revision in most pediatric hydrocephalus cases. Newer devices improved outcomes, but complications like blockage and infection persisted.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Biomedical Engineering
Background:
- Hydrocephalus is a condition characterized by excess cerebrospinal fluid in the brain.
- Ventriculopleural shunts are a surgical option for managing hydrocephalus.
- Early shunt systems had significant complication rates.
Purpose of the Study:
- To evaluate the efficacy and complication rates of ventriculopleural shunts in pediatric hydrocephalus.
- To compare outcomes between early and later series of ventriculopleural shunts.
- To identify common reasons for shunt failure and revision.
Main Methods:
- Retrospective review of pediatric patients undergoing ventriculopleural shunt placement.
- Analysis of shunt function, complications, and need for revision.
- Comparison of outcomes based on shunt system components and time period.
Main Results:
- In the initial series (1969-1979), 18 of 29 patients required shunt revision due to symptomatic pleural effusion.
- In the later series (1979-1982), complications included shunt infection (3 patients), catheter blockage (4 patients), and symptomatic effusion (1 patient).
- Improved shunt systems in the later series demonstrated reduced rates of symptomatic pleural effusion.
Conclusions:
- Ventriculopleural shunts, especially older systems, are associated with a high risk of symptomatic pleural effusion in pediatric hydrocephalus.
- Modifications in shunt apparatus and components may reduce certain complications.
- Ongoing vigilance for shunt infection and blockage remains crucial.