Advertisement

Child's Nervous System

, Volume 11, Issue 3, pp 176–179 | Cite as

Long-term results after ventriculo-atrial shunting in children

  • O. Vernet
  • R. Campiche
  • N. de Tribolet
Original Paper

Abstract

A consecutive series of 120 patients with infantile hydrocephalus who were submitted to ventriculo-atrial shunting was studied. The average follow-up was 11 years. There was no operative mortality; 7 patients died during the follow-up period, but only in 1 case was the cause of death a consequence of the shunt procedure. The incidence rates of infection and slit ventricle syndrome were 4.2% and 1.8%, respectively. Shunt revision was performed on 253 occasions yielding a revision rate of 2.2 per patient. Of these 253 revisions 167 (66%) took the form of elective lengthening of the atrial catheter. The number of reoperations to adjust the length of the atrial catheter or to revise the distal end of the shunting system is a major disadvantage, which actually favors ventriculo-peritoneal shunting as the primary procedure for the treatment of pediatric hydrocephalus.

Key words

Hydrocephalus Ventriculo-atrial shunt Shunt infection 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Andersson H (1966) Craniosynostosis as a complication after operation for hydrocephalus. Acta Paediatr Scand 55:192–196Google Scholar
  2. 2.
    Fokes EC (1970) Occult infections of ventriculoatrial shunts. J Neurosurg 33:517–523Google Scholar
  3. 3.
    Forrest DM, Cooper DGW (1968) Complications of ventriculo-atrial shunts. J Neurosurg 29:506–512Google Scholar
  4. 4.
    George R, Leibrock L, Epstein M (1979) Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience. J Neurosurg 51:804–811Google Scholar
  5. 5.
    Hirsch JF, Hoppe-Hirsch E (1988) Shunts and shunt problems in childhood. In: Symon L, et al (eds) Advances and technical standards in neurosurgery, vol 16. Springer, Wien New York, pp 177–211Google Scholar
  6. 6.
    Huber ZA (1981) Complications of shunt operations performed in 206 children because of communicating hydrocephalus. Zentralbl Neurochir 42:165–170Google Scholar
  7. 7.
    Keucher TR, Mealey J (1979) Longterm results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186Google Scholar
  8. 8.
    Klein DM (1990) Shunt infections. In: Scott RM (ed) Hydrocephalus. (Concepts in neurosurgery, vol 3) Williams & Wilkins, Baltimore, pp 79–97Google Scholar
  9. 9.
    Little JR, Rhoton AL, Mellinger JF (1972) Comparison of ventriculoperitoneal and ventriculoatrial shunts for hydrocephalus in children. Mayo Clin Proc 47:396–401Google Scholar
  10. 10.
    Luthardt T (1970) Bacterial infections in ventriculo-auricular shunt systems. Dev Med Child Neurol Suppl 22:105–1109Google Scholar
  11. 11.
    Nugent GR, Russel L, Judy M, Bloor BM, Warden H (1966) Thromboembolic complications of ventriculo-atrial shunts. Angiocardiographic and pathologic correlations. J Neurosurg 24:34–42Google Scholar
  12. 12.
    Nulsen FE, Spitz EB (1952) Treatment of hydrocephalus by direct shunt from ventricle to jugular vein. Surg Forum 2:239–403Google Scholar
  13. 13.
    Renier D, Lacombe J, Pierre-Kahn A, Sainte-Rose C, Hirsch JF (1984) Factors causing shunt infection. J Neurosurg 61:1072–1078Google Scholar
  14. 14.
    Shapiro S, Boaz J, Kleinman M, Kalsbeck J, Mealey J (1988) Origin of organisms infecting ventricular shunts. Neurosurgery 22:868–872Google Scholar
  15. 15.
    Shurtleff DB, Christie D, Foltz EL (1971) Ventriculoauriculostomy-associated infection. A 12-year study. J Neurosurg 35:686–694Google Scholar
  16. 16.
    Stauffer UG (1970) “Shunt nephritis”: diffuse glomerulonephritis complicating ventriculo-atrial shunts. Dev Med Child Neurol Suppl 22:161–164Google Scholar
  17. 17.
    Steinbok P, Thompson GB (1976) Complications of ventriculo-vascular shunts: computer analysis of etiological factors. Surg Neurol 5:31–35Google Scholar
  18. 18.
    Wisoff JH, Epstein FJ (1990) Diagnosis and treatment of the slit ventricle syndrome. In: Scott RM (ed) Hydrocephalus. (Concept in neurosurgery, vol 3) Williams & Wilkins, Baltimore, pp 79–85Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • O. Vernet
    • 1
  • R. Campiche
    • 1
  • N. de Tribolet
    • 1
  1. 1.Department of NeurosurgeryUniversity HospitalLausanneSwitzerland

Personalised recommendations