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Pediatr Neurosurg. 2017;52(6):381-400. doi: 10.1159/000452840. Epub 2017 Mar 2.

Cerebrospinal Fluid Shunting Complications in Children.

Author information

1
Department of Neurological Surgery, University of Washington and Seattle Children's Hospital, Seattle, WA, USA.

Abstract

Although cerebrospinal fluid (CSF) shunt placement is the most common procedure performed by pediatric neurosurgeons, shunts remain among the most failure-prone life-sustaining medical devices implanted in modern medical practice. This article provides an overview of the mechanisms of CSF shunt failure for the 3 most commonly employed definitive CSF shunts in the practice of pediatric neurosurgery: ventriculoperitoneal, ventriculopleural, and ventriculoatrial. The text has been partitioned into the broad modes of shunt failure: obstruction, infection, mechanical shunt failure, overdrainage, and distal catheter site-specific failures. Clinical management strategies for the various modes of shunt failure are discussed as are research efforts directed towards reducing shunt complication rates. As it is unlikely that CSF shunting will become an obsolete procedure in the foreseeable future, it is incumbent on the pediatric neurosurgery community to maintain focused efforts to improve our understanding of and management strategies for shunt failure and shunt-related morbidity.

KEYWORDS:

Catheter obstruction; Hydrocephalus; Shunt failure; Ventriculoatrial shunt; Ventriculoperitoneal shunt; Ventriculopleural shunt

PMID:
28249297
PMCID:
PMC5915307
DOI:
10.1159/000452840
[Indexed for MEDLINE]
Free PMC Article

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