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Comparative study between ventriculosubgaleal shunt and external ventricular drain for management of post infective

Abdelaziz Abdelhamid Ismail1, Ahmed Nageeb Taha2, Hatem Ibraheem Badr2

  • 1Faculty of Medicine, Neurosurgery Department, Mansoura University, Mansoura, Egypt. abdelaziz.ismael@yahoo.com.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|March 5, 2024
PubMed

Insights

Ventriculosubgaleal shunt (VSGS) is a cost-effective option for managing post-infective hydrocephalus (PIH) in pediatric patients, showing similar complication rates to external ventricular drain (EVD) but with reduced hospital stay and economic burden.

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Disease Management
  • Medical Device Technology

Background:

  • Post-infective hydrocephalus (PIH) requires temporary cerebrospinal fluid (CSF) management.
  • External ventricular drain (EVD) and ventriculosubgaleal shunt (VSGS) are common temporary treatments for PIH.
  • Limited comparative data exists for pediatric PIH management, particularly regarding resource utilization and cost-effectiveness.

Purpose of the Study:

  • To compare the complications, mortality rates, and resource costs of VSGS versus EVD in pediatric PIH patients.
  • To evaluate the efficacy and economic impact of temporary CSF diversion techniques in PIH.

Main Methods:

  • A prospective randomized study involving 42 pediatric patients with PIH.
  • Patients were allocated to either VSGS (Group A, n=21) or EVD (Group B, n=21).
  • Comparison focused on duration of treatment, pediatric intensive care unit (PICU) admission, length of hospital stay (LOS), complications, and mortality.

Main Results:

  • A statistically significant difference was observed in the duration of VSGS/EVD implementation until infection resolution.
  • The EVD group experienced higher rates of PICU admission and longer LOS compared to the VSGS group.
  • No significant difference in the overall number of complications or mortality rates was found between the VSGS and EVD groups.

Conclusions:

  • VSGS and EVD demonstrate comparable complication and mortality rates for managing PIH.
  • VSGS presents a more favorable and cost-effective alternative, reducing the economic burden on healthcare systems, especially in developing nations.
  • VSGS is recommended as a preferred management strategy for pediatric PIH due to its economic advantages and comparable safety profile.
Abstract

Keywords:
External ventricular drainIntracranial pressureMeningitisPost infective hydrocephalusVentriculosubgaleal shunt

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