Systemic Review: Neurological Deficits following Ventriculoperitoneal Shunt (VPS) Insertion

Area of Science:

• Neurosurgery
• Neurology
• Medical Devices

Background:

• Hydrocephalus often necessitates ventriculoperitoneal shunts (VPS) to manage intracranial pressure.
• Neurological impairments following VPS placement are infrequent but documented complications.

Purpose of the Study:

• To systematically review and document neurological deficits arising from ventriculoperitoneal shunt (VPS) procedures.
• To identify the incidence and types of neurological injuries associated with VPS in hydrocephalus patients.

Main Methods:

• A systematic review of PubMed and Cochrane databases from 1975 to December 2021.
• Inclusion criteria: VPS, neurological deficits, human participants. Exclusion criteria: other shunt types, non-human subjects, infection.

Main Results:

• Out of 785 patients, 35 (4.46%) experienced neurological impairments after VPS.
• Cranial nerve palsies (VI, VII) were most common (44%), followed by brainstem (60%) and deep brain structure injuries (20%).
• Underlying conditions like trapped fourth ventricle contributed to deficits in 36% of cases.

Conclusions:

• While VPS is a standard hydrocephalus treatment, potential neurological complications, though rare, must be acknowledged.
• Awareness of these risks, including cranial nerve palsies and brainstem injury, is crucial for patient care and management.