Management of Hydrocephalus with Ventriculoperitoneal Shunts: Review of 109 Cases of Children

Abstract

Background: Treatment of hydrocephalus by shunting procedure is associated with variable outcomes, depending on the setting. Results from some published series in sub-Saharan Africa are not so good and various reasons have been given. This study presents preliminary findings of 109 cases of shunted hydrocephalus in children in a 3-year period.

Objectives: The main aim of the study was to evaluate the complications of the procedure in a tertiary-care center. It also seeks to identify ways of reducing such complications where appropriate in subsequent shunt placement procedures.

Methods: A single-institutional retrospective study was conducted by reviewing 124 patients who had ventriculoperitoneal shunting including revisions, and subgroup analysis was performed in 109 patients younger than 18 years classified as children who had first-time shunt placement between January 2011 and December 2013. Data analysis was performed using Microsoft Excel and SPSS (version 20.0).

Results: The mean age at shunt insertion of the subgroup was 5.35 years ± 1.264 standard deviations. Shunt-related complications were identified in 37 of the patients (33.9%). Infections were the most common form of complication, occurring in 16 patients (14.6%). The overall mortality of the 109 patients was 4.59%.

Conclusions: The most common indications for shunt insertions were tumoral and congenital lesions, which may offer us benefit with the use of endoscopic third ventriculostomy. Comprehensive follow-up of these patients may give a better picture of the magnitude of the problem; hence the need for properly designed prospective studies to improve the current outcomes.

Keywords: Complications; Hydrocephalus; Korle-Bu Teaching Hospital; Outcome; Sub-Saharan Africa; Ventriculoperitoneal shunt.