Skip to main content

Advertisement

Log in

Ventricular shunt survival in children with neural tube defects

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Ventricular shunting has dramatically improved the care of children with hydrocephalus. Yet shunt malfunctions are extremely common and cause significant morbidity. To document shunt problems in children with a neural tube defect and hydrocephalus, 67 children born since 1973 were studied via life-table analysis. 28% of the shunts failed within the first 6 months after insertion, 37% failed within the first year and 50% failed by 4 1/2 years after insertion. Shunt survival was similar in children whether or not they had previous shunt failures. The brand of shunt system and pressure rating, the level of neurological function, the interval between closure of the neural tube lesion and shunt insertion, and head circumference percentile at the time of insertion were also not correlated with shunt failure. However, shunts inserted in the first year of life were much more likely to fail than those inserted after one year of age (p < 0.05). 68% of the revisions required replacement of the ventricular catheter. Shunt failure from all causes of hydrocephalus accounted for approximately 1% of paediatric admissions to Strong Memorial Hospital in 1982 with a mean cost of $ 4,543 and a mean length of stay of 9 days. Thus shunt problems remain both common and serious.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ambrosio, A., Benvenuti, L., Bianchi, E., Briani, S.,et al., Longterm results of the operative treatment of hydrocephalus in children. Adv. Neurol.8 (1980), 187–190.

    Google Scholar 

  2. Basauri, L., Zuleta, A., Shunts and shunt problems. Monographs in Neural Sciences8 (1982), 12–15.

    Google Scholar 

  3. Bradbury, M., The Concept of a Blood-Brain Barrier. New York: Wiley. 1979.

    Google Scholar 

  4. Breslow, N. A., Generalized Kruskal-Wallis test for comparing K samples subject to unequal patterns of censorship. Biometrika57 (1970), 579–594.

    Google Scholar 

  5. Chan, L. S., Powars, D., Lee, J.,et al., A modified life table method to study congenital genetic disorders: an application in sickle cell anemia. J. Chronic Disease35 (1982), 401–409.

    Google Scholar 

  6. Forrest, D. M., Cooper, D. G., Complications of ventriculoatrial shunts. J. Neurosurg.29 (1968), 506–512.

    Google Scholar 

  7. Hemmer, R., A survey of complications their avoidance and results in ventriculo-atrial shunts from 1961 to 1978. Monographs in Neural Sciences8 (1982), 7–11.

    Google Scholar 

  8. Hoffman, H. J., Hendrick, E. B., Humphreys, R. P., Management of hydrocephalus. Monographs in Neural Sciences8 (1982), 21–25.

    Google Scholar 

  9. Hull, C. H., Nie, N. H. (Eds.), SPSS Update 7–9. New Procedures and Facilities for Release 7–9, pp. 205–219. New York: McGraw-Hill. 1981.

    Google Scholar 

  10. Keucher, T. R., Mealey, J., Long-term results after ventriculoatrial and ventriculo-peritoneal shunting for infantile hydrocephalus. J. Neurosurg.50 (1979), 179–186.

    PubMed  Google Scholar 

  11. Klinger, M., Grohmann, G., Haubner, W.,et al., Long-term results of shunt operations over a period of 10 years. Adv. Neurol.8 (1980), 217–221.

    Google Scholar 

  12. Leem, W., Miltz, H., Complications following ventriculo-atrial shunts in hydrocephalus. Adv. Neurol.6 (1978), 1–5.

    Google Scholar 

  13. Liesegang, J., Strahl, E. W., Streicher, H. R., Complications following shunt operations in children. Adv. Neurol.8 (1980), 222–226.

    Google Scholar 

  14. Little, J. R., Rhoton, A. L., Mellinger, J. F., Comparison of ventriculo-peritoneal and ventriculo-atrial shunts for hydrocephalus in children. Mayo Clinic Proceedings47 (1972), 396–401.

    PubMed  Google Scholar 

  15. Lorber, J., Pucholt, V., Long term assessment of shunts in hydrocephalus. Z. Kinderchirurgie34 (1981), 320–326.

    Google Scholar 

  16. Lorber, J., Salfield, S., Lonton, T., Isosorbide in the management of infantile hydrocephalus. Develop. Med. Child Neurol.25 (1983), 502–511.

    PubMed  Google Scholar 

  17. McLone, D. G., Czyzewski, D., Raimondi, A. J., Sommers, R. C., Central nervous system infections as a limiting factor in the intelligence of children with myelomenigocele. Pediatrics70 (1982), 338–342.

    Google Scholar 

  18. Milhorat, T. H., Hydrocephalus: historical notes, etiology and clinical diagnosis. In: Section of Pediatric Neurosurgery of the American Association of Neurological Surgeons, eds. Pediatric Neurosurgery: Surgery of the Developing Nervous System. New York: Grune and Stratton. 1982.

    Google Scholar 

  19. National Center for Health Statistics: Annual summary of births, deaths, marriages and divorces: United States 1982. Monthly Vital Statistics Report 1983;31 (13), 1–28.

  20. Olsen, L., Frykberg, T., Complications in the treatment of hydrocephalus in children. Acta Paediatr. Scand.72 (1983), 385–390.

    PubMed  Google Scholar 

  21. Portnoy, H. D., Treatment of hydrocephalus. In: Section of Pediatric Neurosurgery of the American Association of Neurological Surgeons, eds. Pediatric Neurosurgery: Surgery of the Developing Nervous System. New York: Grune and Stratton. 1982.

    Google Scholar 

  22. Strahl, E. W., Liesegang, J., Roosen, K., Complications following ventriculo-peritoneal shunts. Adv. Neurol.6 (1978), 6–9.

    Google Scholar 

  23. Usher, R., McLean, F., Intrauterine growth of live-born Caucasian infants at sea level: Standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J. Pediatr.74 (1969), 901–910.

    PubMed  Google Scholar 

  24. Wallman, L. J., Shunting for hydrocephalus: an oral history. Neurosurgery11 (1982), 308–313.

    PubMed  Google Scholar 

  25. Widell, S., On the cerebrospinal fluid in normal children and in patients with acute bacterial meningo-encephalitis. Acta Paediat.47 (Suppl. 115) (1958), 1–102.

    Google Scholar 

  26. Windham, G. C., Edmonds, C. D., Current trends in the incidence of neural tube defects. Pediatrics (1982), 333–337.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liptak, G.S., Masiulis, B.S. & McDonald, J.V. Ventricular shunt survival in children with neural tube defects. Acta neurochir 74, 113–117 (1985). https://doi.org/10.1007/BF01418798

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01418798

Keywords

Navigation