Shunt Revision Overview in Patients with Hydrocephalus
Background: Hydrocephalus is a notorious neurosurgical disease that carries the adage “once a shunt always a shunt.” Most patients with hydrocephalus are treated with ventriculo‐peritoneal (VP) shunt placement; however, malfunction is common and is usually caused by mechanical failure. Aim: To evaluate the patients who were in need for shunt revision, analyzing them according to their age, sex, and causes of their hydrocephalus, and investigating the etiological causes for their revisions. Patients and Methods: In a retrospective study, the records of 90 patients who underwent their shunt revision in the Neurosurgical hospital and neurosurgical departments of AL‐Kadhmia teaching hospital and the hospital of surgical specialties between January 2000 till June 2002 were analyzed peri‐operatively Results: It was revealed that most of the revised patients were children (their age≤10). The majority of them were shunted at ﬁrst due to congenital hydrocephalus and acquired hydrocephalus respectively. Regarding the frequency of revision in these patients the majority were revised once and few of them were revised for more than one time. Peri‐operatively clinical status of shunt function was determined which showed upper end block in 27.8%, post‐operative meningitis in 13.3%. Yet, lower end block was found in 10% of the cases. Conclusion: Shunt failure is still far too common especially in pediatric age groups. Upper end block together with surgical errors and suboptimal techniques plays a significant role in shunt revision.