Child's Nervous System

, Volume 24, Issue 2, pp 197–201 | Cite as

Death in shunted hydrocephalic children: a follow-up study

  • Leslie Acakpo-Satchivi
  • Chevis N. Shannon
  • R. Shane TubbsEmail author
  • John C. WellonsIII
  • Jeffrey P. Blount
  • Bermans J. Iskandar
  • W. Jerry Oakes
Original Paper



The authors previously conducted a retrospective study regarding deaths from CSF shunt failure to identify circumstances surrounding shunt malfunction-related deaths in children in the modern era.

Materials and methods

Using the same methodology, we conducted a follow-up study to determine whether recent policy and procedural changes instituted since the time of the first study had effected a change in the mortality rate of our shunted patient population.


Thirty-nine original patient records (of patients seen at Children’s Hospital who died with the diagnosis of hydrocephalus between 1998 and 2004) were identified and reviewed for inclusion into the study. Only four (10.3%) were found to have died directly as a result of shunt malfunction.


Our rate of shunt malfunction death has decreased over time. It is reasonable to attribute part of this decline to continued improvements in diagnostic and therapeutic techniques and to the use of surveillance scans to identify asymptomatic patients with shunt failure. However, we believe the majority of this decline is due to two additional factors: (1) increased nursing staff and (2) effective patient/family education.


Hydrocephalus Pediatric neurosurgery Mortality 



The authors wish to thank the State of Alabama Department of Public Health, Center for Health Statistics for its assistance in gathering data for this study.


  1. 1.
    Bryant MJ, McEniery J, Walker DG, Campbell R, Lister B, Sargent P, Withers TK, Baker J, Guazzo E, Rossato R, Anderson D, Tomlinson F (2004) Preliminary study of shunt related death in paediatric patients. J Clin Neurosci 11:614–615PubMedCrossRefGoogle Scholar
  2. 2.
    Di Rocco C, Marchese E, Velardi F (1994) A survey of the first complication of newly implanted CSF shunt devices for the treatment of nontumoral hydrocephalus. Cooperative survey of the 1991–1992 Education Committee of the ISPN. Childs Nerv Syst 10:321–327PubMedCrossRefGoogle Scholar
  3. 3.
    Iskandar BJ, Sansone JM, Medow J, Rowley HA (2004) The use of quick-brain magnetic resonance imaging in the evaluation of shunt-treated hydrocephalus. J Neurosurg 101:147–151PubMedGoogle Scholar
  4. 4.
    Iskandar BJ, Tubbs S, Mapstone TB, Grabb PA, Bartolucci AA, Oakes WJ (1998) Death in shunted hydrocephalic children in the 1990s. Pediatr Neurosurg 28:173–176PubMedCrossRefGoogle Scholar
  5. 5.
    Lee TT, Uribe J, Ragheb J, Morrison G, Jaqid JR (1999) Unique clinical presentation of pediatric shunt malfunction. Pediatr Neurosurg 30:122–126PubMedCrossRefGoogle Scholar
  6. 6.
    Liptak GS, Bolander HM, Langworthy K (2001) Screening for ventricular shunt function in children with hydrocephalus secondary to meningomyelocele. Pediatr Neurosurg 34:281–285PubMedCrossRefGoogle Scholar
  7. 7.
    McGirt MJ, Leveque JC, Wellons JC 3rd, Villavicencio, Hopkins JS, Fuchs HE, George TM (2002) Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg 36:248–255PubMedCrossRefGoogle Scholar
  8. 8.
    Tuli S, Tuli J, Drake J, Spears J (2004) Predictors of death in pediatric patients requiring cerebrospinal fluid shunts. J Neurosurg 100:442–446PubMedGoogle Scholar
  9. 9.
    Vinchon M, Fichten A, Delestret I, Dhellemmes P (2003) Shunt revision for asymptomatic failure: surgical and clinical results. Neurosurgery 52:347–353, discussion 353–346PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Leslie Acakpo-Satchivi
    • 1
  • Chevis N. Shannon
    • 1
  • R. Shane Tubbs
    • 1
    • 2
    Email author
  • John C. WellonsIII
    • 1
  • Jeffrey P. Blount
    • 1
  • Bermans J. Iskandar
    • 3
  • W. Jerry Oakes
    • 1
  1. 1.Pediatric NeurosurgeryChildren’s HospitalBirminghamUSA
  2. 2.Department of Cell BiologyUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Department of NeurosurgeryUniversity of Wisconsin Medical SchoolMadisonUSA

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