Ventriculosubgaleal shunt as a proposed technique for post-infectious hydrocephalus

Abstract

Background The management of post-infectious hydrocephalus (PIH) remains challenging for neurosurgeons. It requires a temporary diversion procedure till the normalization of CSF parameters prior to the permanent one. Ventriculosubgaleal shunt (VSGS) was widely used in pediatric cases with post-hemorrhagic hydrocephalus (PHH). However, its role in PIH is still lacking. This study was done to elucidate the safety and efficacy of VSGS as a temporary CSF diversion procedure before the permanent one in patients with PIH. Patients and methods This retrospective investigation analyzed the data of 50 consecutive cases who underwent VSGS for PIH. Results The age of the included patients ranged between 1 and 10 months. Twenty-six cases had meningitis and or ventriculitis (52%), while the remaining had shunt infection. At follow-up, arresting of hydrocephalus was noted in ten patients (20%), while another 36 cases required the permanent diversion procedure within 35 days. Regarding the shunt complications, scalp infection, tissue breakdown, and shunt exposure were encountered in ten cases (20%), while CSF leakage was noted in 12 cases (24%). Shunt migration was noted in only two patients (4%). Shunt revision was needed in 16 cases (32%). Mortality was encountered in four cases (8%) because of sepsis. Risk factors for morbimortality included younger age, lower weight, male gender, and meningitis and or ventriculitis. Conclusion VSGS is a safe and effective procedure in infants awaiting definitive VPS for postinfectious hydrocephalus. It was proven that VSGS has shortened the hospital stay and the economic burden on the country.

Comparative study between Ventriculo Subgaleal Shunt and External Ventricular Drain for management of post infective Hydrocephalus among pediatrics.

“…Table (2) shows no statistically signi cant difference between studied groups as regard complications incidence. The most frequent complications were Blockage &pouch collapse and devitalized wound & CSF leak Table (3) demonstrates A statistically signi cant higher frequency of PICU admission among group B than group A (80.9% versus 23.8%, respectively).…”

“…When hydrocephalus occurs following cerebral pyogenic or chronic infections, it is referred to as "post-infective" hydrocephalus (PIH). In rare condition, HCP might happen following fungal or viral infections of the brain [1,2].…”

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

“…When hydrocephalus occurs following cerebral pyogenic or chronic infections, it is referred to as “post-infective” hydrocephalus (PIH). In rare condition, HCP might happen following fungal or viral infections of the brain [ 1 , 2 ].…”