Results of Treatment with Ventriculoatrial and Ventriculoperitoneal Shunt in Infantile Nontumoral Hydrocephalus

Abstract

The technique of femoral-cerebral catheterization in infants and children is described, and a series of 1,869 procedures is analyzed for complications. Clinical complications occurred in 12 of 678 or 1.8% of examinations while radiographic complications were discovered in 38 of 1,869 or 1.1% of procedures. The results are compared to a similar retrospective study of a large series (2,184 procedures) of direct puncture/retrograde brachial studies in a similar patient population at the same institution in which there was a 2.6% clinical complication rate and a 4.3% radiographic complication rate. Those factors which predispose to complications, clinical or radiographic, are more pronounced in the younger age groups but affect the direct puncture/retrograde brachial technique to a greater degree. The lower morbidity, greater selectivity and improved comfort make the femoral-cerebral route preferable for neuroangiographic studies in infants and children.

Risk of infection after cerebrospinal fluid shunt: An analysis of 884 first-time shunts

“…Previous reports have shown a rate of infection between 1.5% and 22% after VA or VP shunt operations [13,16,25,35,36,38,40,53], a variation, which may partly be caused by the different designs of the investigations. The number of infections are either related to lvhe number of patients [22,25,31] or to the number of procedures, inclusive of revisions [16,40]. In some investigations no differentiation at all was given [35,47,53].…”

Infantile Hydrocephalus: Long-Term Results of Surgical Therapy

“…Keucher and Mealey [13] lost 2.4% of the patients per year, 16.2% over a 0-to > 10-year follow-up. Little et al [14] lost 13.5% of their series over 2 years, while Mazza et al [15] had an 18% mortality over a I -to 11-year follow-up in nonneoplastic cases.…”

“…Neurosurgeons report an operative infection risk of 3-20% and an overall infection rate of up to 30% [1,4,II,[13][14][15][16][17][18][19]24], Various technical solutions have been proposed. Raimondi et al [19] stated that the use of a one-piece shunt system would reduce the cumula tive risk of infection for the patient, in their experience from 34 to 20%.…”

Migration of Ventriculoperitoneal Shunt into the Heart. Case Report.

“…11) Several complications besides obstruction and infection have been reported such as intraabdominal pseudocyst, 7,16) volvulus, 17) bowel obstruction, 7) extrusion of the peritoneal catheter through the vagina, 13) umbilicus, 2) surgical wound, 4) and lumbar region, 9) and migration of the catheter into various sites including the bowel, 1,7,18) scrotum, 7) urinary bladder, 7) and ventricle. 12,14) Intraabdominal complications occurred in 24% of hydrocephalic infants and children after VP shunting.…”