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Updated: Dec 21, 2025
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
CSF levels of myelin basic protein in pediatric patients with ventriculoperitoneal shunt infection
Bartosz Polis1, Lech Polis1, Krzysztof Zeman1
1Polish Mother's Memorial Hospital Research Institute, Łódź, Poland.
Insights
Pediatric patients with ventriculoperitoneal shunt infection show elevated cerebrospinal fluid myelin basic protein (MBP) levels, indicating ongoing neuronal damage. MBP levels remain high longer than other inflammatory markers.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Biomarker Research
Background:
- Hydrocephalus is a common pediatric central nervous system (CNS) disorder requiring surgical intervention.
- Ventriculoperitoneal shunt (VPS) placement is a primary treatment, but infection is a significant complication.
- VPS infection can lead to neuronal damage, necessitating reliable markers for assessment.
Purpose of the Study:
- To evaluate cerebrospinal fluid (CSF) myelin basic protein (MBP) levels in pediatric patients diagnosed with VPS infection.
- To determine if MBP can serve as an indicator of neuronal injury in the context of shunt infection.
Main Methods:
- Collected 30 CSF samples from pediatric patients with VPS infection.
- Measured CSF MBP levels at three distinct time points post-infection.
- Compared MBP levels with a control group of children with congenital hydrocephalus.
Main Results:
- CSF MBP levels were significantly higher in the infected group compared to controls at later time points.
- The highest MBP levels were observed during the second and third measurements in the infected cohort.
- Elevated MBP levels persisted, suggesting ongoing neurological insult.
Conclusions:
- Sustained elevation of CSF MBP in pediatric shunt infection indicates persistent brain damage.
- MBP normalization lags behind other inflammatory markers like CSF protein and pleocytosis.
- This delay may reflect a prolonged immunological response to the infection.
Introduction:
Hydrocephalus is a common disorder of the central nervous system (CNS) in the pediatric population. Surgical treatment options involve ventriculoperitoneal shunt (VPS) placement. VPS infection is the most common complication of surgically treated hydrocephalus in pediatric patients [1, 2],which may lead to neuronal damage. Myelin basic protein (MBP) has been proposed as a marker of neuronal injury in a variety of contexts, and MBP levels in the cerebrospinal fluid (CSF) may be used to assess the severity of neuronal damage [1, 3, 4]. Therefore, the aim of this study was to evaluate the CSF level of myelin basic protein (MBP) in a group of pediatric patients with VPS infection.
Material And Methods:
Thirty CSF samples were collected from pediatric patients with VPS infection. CSF levels of MBP were measured at three time points, marked by contamination detection, obtention of the first sterile CSF culture, and VPS shunt implantation. The collected data were compared with those of the control group composed of children with active congenital hydrocephalus and valid CSF values.
Results:
The MBP level in the study group was higher than the corresponding control values in the second and third measurements. The highest MBP level was reached in the study group in the second and third measurements.
Conclusions:
The lack of normalization of MBP level in the CSF of children with shunt infection could be connected with ongoing brain damage. It takes longer than the normalization of CSF protein level and pleocytosis. The delay is associated with a prolonged reaction of the immunological system.
