Mauro Dobran1, Davide Nasi2, Fabrizio Mancini1, Maurizio Gladi1, Gabriele Polonara3, Alessandra Marini1, Simona Lattanzi4, Massimo Scerrati1. 1. Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy. 2. Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy. Electronic address: davide.nasi@ospedaliriuniti.marche.it. 3. Neuroradiological Department, Università Politecnica delle Marche, Ancona, Italy. 4. Neurology Department, Università Politecnica delle Marche, Ancona, Italy.
Abstract
OBJECTIVE: Ventriculoperitoneal (VP) shunt is the most common neurosurgical procedure to treat obstructive and communicating hydrocephalus, but failures are frequent. The most common causes of shunt failure are malpositioning and obstruction of the ventricular catheter by debris or blood clothes. The knowledge of the relationship between ventricular catheter tip position, etiology of hydrocephalus and patient's age with shunt malfunction may be useful to avoid shunt failure. PATIENTS AND METHODS: We retrospectively analyze 89 adult patients affected by obstructive and communicating hydrocephalus operated with Ventriculoperitoneal shunt at our Institute. Patients with evident abdominal shunt malfunction were excluded from this study. Statistical analysis was performed in the group of patients with intracranial catheter malfunction in order to correlate shunt malfunction with the position of the catheter tip in brain ventricles, etiology of hydrocephalus and patient's age. RESULTS: Shunt revision was performed in 26 patients out of 89 and cranial catheter malfunction was documented in 11 patients out of 26. Tip position in Monro foramen, lateral ventricles and third ventricle ("good position") had a lower rate of surgical shunt revision compared to septum pellucidum and wall of lateral ventricle ("bad position") p value = 0,049. No statistical significant association was observed between shunt malfunction and etiology of the hydrocephalus or patient's age. CONCLUSIONS: Ventricular catheter tip position is one the most important factor for shunt function.
OBJECTIVE: Ventriculoperitoneal (VP) shunt is the most common neurosurgical procedure to treat obstructive and communicating hydrocephalus, but failures are frequent. The most common causes of shunt failure are malpositioning and obstruction of the ventricular catheter by debris or blood clothes. The knowledge of the relationship between ventricular catheter tip position, etiology of hydrocephalus and patient's age with shunt malfunction may be useful to avoid shunt failure. PATIENTS AND METHODS: We retrospectively analyze 89 adult patients affected by obstructive and communicating hydrocephalus operated with Ventriculoperitoneal shunt at our Institute. Patients with evident abdominal shunt malfunction were excluded from this study. Statistical analysis was performed in the group of patients with intracranial catheter malfunction in order to correlate shunt malfunction with the position of the catheter tip in brain ventricles, etiology of hydrocephalus and patient's age. RESULTS: Shunt revision was performed in 26 patients out of 89 and cranial catheter malfunction was documented in 11 patients out of 26. Tip position in Monro foramen, lateral ventricles and third ventricle ("good position") had a lower rate of surgical shunt revision compared to septum pellucidum and wall of lateral ventricle ("bad position") p value = 0,049. No statistical significant association was observed between shunt malfunction and etiology of the hydrocephalus or patient's age. CONCLUSIONS:Ventricular catheter tip position is one the most important factor for shunt function.
Authors: Daniel Alejandro Vega-Moreno; María Elena Córdoba-Mosqueda; José Ramón Aguilar-Calderón; Rodrigo Efraín Hernández-Resendiz; Heberseleth Valdivia-Chiñas; Erick Alberto Castañeda-Ramírez; Óscar Medina-Carrillo; Rafael Sánchez-Mata Journal: Ann Med Surg (Lond) Date: 2020-08-21
Authors: Prashant Hariharan; Jeffrey Sondheimer; Alexandra Petroj; Jacob Gluski; Andrew Jea; William E Whitehead; Sandeep Sood; Steven D Ham; Brandon G Rocque; Neena I Marupudi; James P McAllister; David Limbrick; Marc R Del Bigio; Carolyn A Harris Journal: Fluids Barriers CNS Date: 2021-07-21