Shunt complications and revisions in children: A retrospective single institution study

Mansoor, Nadia; Solheim, Ole; Fredriksli, Oddrun; Gulati, Sasha

doi:10.1002/brb3.2390

Cited by 22 publications

(11 citation statements)

References 46 publications

(69 reference statements)

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“…There was a significant association between number of revisions and outcome, where 100% of patients with three revisions had unfavorable outcome versus 20% among patients without previous revisions (p-value<0.001). According to Mansoor et al (11) , 81 patients underwent 206 surgeries in the study period. 47 patients (58%) required a minimum of one revision during follow-up.…”

Section: Discussionmentioning

confidence: 99%

Management and Outcome Predictors of Pediatric Cerebrospinal Fluid Shunt Infections

Youssef¹,

Rashed²,

Elsayed³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Cerebrospinal fluid Shunts can cause a number of complications, the most prevalent one is infection. Infection causes significant morbidity, particularly in pediatrics more than adults, and its management is extremely challenging for healthcare systems.Objective: This study aimed to determine the outcome predictors of pediatric shunt infections to achieve the best management plans. Patients and methods: A prospective observational cohort study was conducted in Intensive Care

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Section: Discussionmentioning

confidence: 99%

Management and Outcome Predictors of Pediatric Cerebrospinal Fluid Shunt Infections

Youssef¹,

Rashed²,

Elsayed³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…Moreover, severe IVH that requires shunt insertion poses a great risk for adverse neurodevelopmental outcomes when compared to IVH without a shunt [ 1 ]. And prolonged and frequent treatments for shunt-related complications including revision could be one of the factors associated with increased disability and reduced quality of life [ 51 , 60 ]. Meanwhile, approximately 20–30% of extreme preterm survivors (gestational age <28 weeks) with IVH were diagnosed with cerebral palsy (CP), 30–35% with minor motor dysfunction which was not enough to be diagnosed with CP, 20% with a major neurosensory disability, and 15% with impaired academic skills [ 44 , 88 ].…”

Section: Long-term Outcome Of Ivh At Preterm Birth Based On the Clini...mentioning

confidence: 99%

The Long-Term Outcome and Rehabilitative Approach of Intraventricular Hemorrhage at Preterm Birth

Hong¹,

Rha²

2023

J Korean Neurosurg Soc

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Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles.During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.

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“…[16] The most frequent cause of shunt malfunction is occlusion of the proximal catheter which can be caused by choroid plexus or ventricular debris. [15,[17][18][19] This limitation emphasizes the need for alternative approaches to address hydrocephalus more effectively.…”

Section: Introductionmentioning

confidence: 99%

Artificial arachnoid granulation: sub-mmduckbill valve for hydrocephalus treatment

Jung,

Gulick,

Christen

2024

Preprint

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Purpose: Hydrocephalus is characterized by the accumulation of excess cerebrospinal fluid (CSF) in the cranium due to an imbalance between production and absorption of CSF. The standard treatment involves the implantation of a shunt to divert excess CSF into the peritoneal cavity, but these shunts exhibit high failure rates over time. In pursuit of improved reliability and performance, this study proposes a miniaturized valve designed to mimic the natural one-way valve function of the arachnoid granulations and thereby replace the shunts. Methods: A benchtop testing setup was employed to characterize the behavior of the fabricated valve. Additionally, an animal study was conducted to assess the valve's in vivo: performance. This involved the injection of saline into the lateral ventricle to elevate intracranial pressure (ICP), followed by the drainage of the saline through the valve inserted into the cisterna magna (CM) to reduce pressure. Results: Our prototype features a silicone duckbill valve design combined with a silicone tube as an inlet. Through benchtop testing, the valve exhibited unidirectional flow with negligible reverse leakage, revealing that critical parameters such as the width of the fluid channel (W) and bill length (L) could be controlled to optimize valve performance. Notably, the valve configuration with W = 0.8 mm and L $<$0.5 mm achieved the lowest cracking pressure (2.22 $\pm$ 0.07 mmHg) and outflow resistance (22.00 $\pm$ 0.70 mmHg/mL/min) within the low cracking pressure range of conventional shunts. Our observations demonstrated that when the valve was closed, pressure differences from baseline to peak exceeded 20 mmHg due to the absence of drainage, resulting in sustained pressure elevation. Conversely, upon opening the valve by removing the clamp, pressure differences from baseline to peak remained below 5 mmHg, indicating effective drainage of injected saline through the valve. Conclusion: These promising results highlight the potential of the miniaturized duckbill valve as an alternative for ICP management in hydrocephalus, offering improved control and reliability compared to conventional shunting systems. Further research is required to evaluate the valve’s performance as a chronic implant.

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Shunt complications and revisions in children: A retrospective single institution study

Abstract: Introduction: Shunt surgery in children is associated with high revision and complication rates. We investigated revision rates and postoperative complications to specify current challenges associated with pediatric shunt surgery.

Cited by 22 publications

References 46 publications

Management and Outcome Predictors of Pediatric Cerebrospinal Fluid Shunt Infections

Management and Outcome Predictors of Pediatric Cerebrospinal Fluid Shunt Infections

The Long-Term Outcome and Rehabilitative Approach of Intraventricular Hemorrhage at Preterm Birth

Artificial arachnoid granulation: sub-mmduckbill valve for hydrocephalus treatment

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