Surgery of Cranial Deformity Following Ventricular Shunting: A Multicenter Study

Area of Science:

• Pediatric Neurosurgery
• Craniofacial Surgery

Background:

• Hydrocephalus is a common condition in pediatric patients requiring cerebrospinal fluid diversion.
• Ventricular shunting procedures, while life-saving, can lead to secondary complications.
• Craniosynostosis, premature fusion of skull sutures, is a potential complication of shunting.

Purpose of the Study:

• To investigate the incidence and characteristics of craniosynostosis secondary to ventriculoperitoneal shunting in pediatric patients.
• To identify risk factors and clinical presentation of shunt-induced craniosynostosis.

Main Methods:

• Retrospective review of medical records of pediatric patients treated with ventriculoperitoneal shunts between 2017 and 2021.
• Inclusion criteria: pediatric patients with hydrocephalus undergoing shunt placement.
• Data collected included age at shunt insertion, time to synostosis development, and type of synostosis.

Main Results:

• Twenty-one pediatric patients were included in the study.
• The median age at shunt insertion was 8.1 months; mean time to secondary synostosis was 8.8 months.
• Plagiocephaly was the most common type of secondary craniosynostosis; 16 patients required shunt revision, and 5 underwent cranial vault expansion.

Conclusions:

• Slit ventricle syndrome is a frequent complication in shunted patients, though treatment consensus is lacking.
• Programmable valves and cranial vault modeling are potential treatment options.
• Increased awareness and early diagnosis of secondary craniosynostosis are vital for timely intervention and preventing severe deformities.