Late Complications of Shunts

  • Paolo Frassanito
  • Simone Peraio
  • Concezio Di Rocco
Living reference work entry

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Extra-thecal shunting of the cerebrospinal fluid (CSF) remains the primary treatment option for pediatric hydrocephalus, despite the rate of failure in children is higher than adults, with significant medical and social burden.

Although the majority of shunt revisions occur during the first 6 months after shunt placement and may be accordingly classified as early failures, the risk of shunt malfunction persists through the entire life of the patient.

In cases of late complications, clinical onset and symptomatology vary according to the functionality of the shunting device. In fact, we may further distinguish late complications due to the failure of the shunt and a second category of complications occurring despite a correctly working shunt. The former group includes all the complications related to the nature of the shunting device as a foreign body, further classified as infectious or mechanical.

The latter group includes complications related to the function of the shunting device and the subsequent chronic drainage of CSF, affecting either the CSF receiving site, for example, ascites and hydrocele for VP shunt and cor pulmonale and nephritis for VA shunt, or the intracranial compartment, namely, the acquired craniocerebral disproportion (ACCD) and the slit ventricle syndrome (SVS).


Acquired craniocerebral disproportion Complications Hydrocephalus Slit ventricle syndrome Endoscopic third ventriculostomy Shunt infection Ventriculo atrial shunt Ventriculo peritoneal shunt 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Paolo Frassanito
    • 1
  • Simone Peraio
    • 1
  • Concezio Di Rocco
    • 2
  1. 1.Pediatric NeurosurgeryFondazione Policlinico Universitario A. Gemelli, Catholic University Medical SchoolRomeItaly
  2. 2.Department of NeurosurgeryInternational Neuroscience InstituteHannoverGermany

Section editors and affiliations

  • Concezio Di Rocco
    • 1
  • Gianpiero Tamburrini
    • 2
  1. 1.Director of Pediatric NeurosurgeryInternational Neuroscience InstituteHannoverGermany
  2. 2.Pediatric Neurosurgery, Institute of NeurosurgeryCatholic University Medical SchoolRomeItaly

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