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Surgery of Cranial Deformity Following Ventricular Shunting: A Multicenter Study
Burak Gezer1, Mevlut Ozgur Taskapilioglu, Murat Zaimoglu
1Selcuk University, Faculty of Medicine, Department of Neurosurgery, Konya, Turkey.
Insights
Secondary craniosynostosis can occur after ventriculoperitoneal shunt placement in pediatric hydrocephalus patients. Early diagnosis and intervention are crucial to prevent severe deformities.
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.
Aim:
To review the cases of craniosynostosis secondary to ventricular shunting procedure.
Material And Methods:
We retrospectively evaluated the medical records of all pediatric patients with hydrocephalus who were treated with ventriculoperitoneal shunt procedure between the years 2017 and 2021 at the Selcuk University, Ankara University, and Bursa Uludag University.
Results:
Twenty-one patients were included in the study. The median age at the time of insertion of ventriculoperitoneal shunt for hydrocephalus was 8.1 (range, 1?22) months. Seven patients were shunted because of congenital hydrocephalus. The mean time to development of secondary synostosis was 8.8 (range, 1?36) months. Plagiocephaly was the most common type of secondary synostosis. While shunt revision was performed in 16 patients, cranial vault expansion surgery was performed in 5 patients.
Conclusion:
Slit ventricle syndrome is a frequent condition at shunted patients, but there is no consensus on identifying patients who require treatment. Using programmable or high-pressure valves, performing cranial vault modeling are possible treatment modalities. Increased awareness of this condition in follow-up may allow early diagnosis and intervention and prevent it from evolving into more serious deformities.
