Cerebrospinal fluid shunt complications: an emergency medicine perspective

Shunt malfunction and shunt infections are the most significant complications associated with cerebrospinal fluid shunts. Most cases of shunt infection are due to S. epidermidis or S. aureus. Seventy percent of all shunt infections present within two months of the shunt surgery. The most common factor associated with shunt infection is age under three months. Even fever may not be a consistent sign of shunt infection. A high index of suspicion for shunt infection or malfunction must be maintained when evaluating the patient with a cerebrospinal fluid shunt. There are many types of shunt systems in use today. An understanding of current shunt systems and their associated problems should allow physicians to promptly diagnose and initiate treatment for patients with cerebrospinal fluid shunts. Prompt neurosurgical consultation is mandatory whenever shunt malfunction or infection is suspected.