Complications in the treatment of hydrocephalus in children. A comparison of ventriculoatrial and ventriculoperitoneal shunts in a 20-year material.

Two homogenous materials of hydrocephalic children operated upon during a 20-year period (1961-1980) are compared. During the first half of the period the ventriculoatrial shunt was the only type used in 103 patients. After that there was a change to the ventriculoperitoneal shunt which was used in 104 patients, whereof 35 were converted from ventriculoatrial to ventriculoperitoneal shunts. Thus the material consists of 172 patients. The complications were less serious and the mortality rate much lower with the ventriculoperitoneal method. The revision rate, however, was about the same for both types of operation, but the revisions and the operative procedure for peritoneal shunts were generally much more simple and more rapidly performed. Therefore it is our opinion that in children the ventriculoperitoneal route is preferable to the ventriculoatrial route. With better knowledge of the underlying cause of distal obstructions in the former route we think that it will be possible to reduce the complication and revision rates even further.