Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;39(2):395-401.
doi: 10.1007/s00381-022-05733-y. Epub 2022 Nov 5.

The role of surgery in relieving calcified shunt site-related pain in patients with functioning VP shunt

Rehman Ali Baig  1   2 , James Davis  3 , Desiderio Rodrigues  3 , William B Lo  3 , Chandrasekaran Kaliaperumal  4 , Pasquale Gallo  3   4
Affiliations

The role of surgery in relieving calcified shunt site-related pain in patients with functioning VP shunt

Rehman Ali Baig et al. Childs Nerv Syst. 2023 Feb.

Abstract

Purpose: Shunt calcification is a known late sequela of ventriculoperitoneal (VP) shunt insertion and is associated with shunt malfunction. However, in some patients, while shunt functionality is preserved despite calcification of the catheters, they experience nociceptive symptoms. In this paper, the authors present their surgical experience in managing patients with a functional VP shunt and experiencing pain secondary to shunt calcification.

Methods: We analysed outcomes of patients presenting with pain at the level of a calcified shunt who underwent surgical untethering of the calcified catheter from the soft tissues. This procedure was commenced by the senior author in 2015. Patients were collected prospectively from the databases of two institutions. Evidence of shunt calcification was confirmed on neuroimaging.

Results: Seven patients, two male and five female, were included. The mean age at untethering was 13.5 years. The mean time interval between primary shunt surgery and symptom onset was 12 years (range 6-16 years). The commonest site of tethering was the neck (50%) followed by abdomen and chest (both 25%). Six patients underwent untethering of the catheter from soft tissues. One patient had removal of a redundant segment of calcified shunt left in situ during a previous revision. All patients experienced pain relief following shunt untethering.

Conclusion: Untethering of calcified VP shunt catheters from soft tissue can be considered an effective treatment of shunt site pain and offered to patients presenting with a functional VP shunt.

Keywords: Calcified shunt; Complications; Pain; Ventriculoperitoneal shunt.

PubMed Disclaimer

References

    1. Vinchon M, Rekate H, Kulkarni AV (2012) Pediatric hydrocephalus outcomes: a review. Fluids Barriers CNS 9(1):18. Published 2012 Aug 27. https://doi.org/10.1186/2045-8118-9-18
    1. Mitchell KS, Zelko I, Shay T et al (2021) The impact of hydrocephalus shunt devices on quality of life. J Craniofac Surg 32(5):1746–1750. https://doi.org/10.1097/SCS.0000000000007579 - DOI - PubMed
    1. Salim AD, Elzain MA, Mohamed HA, Ibrahim Zayan BE (2015) Shunt tube calcification as a late complication of ventriculoperitoneal shunting. Asian J Neurosurg 10(3):246–249. https://doi.org/10.4103/1793-5482.161321 - DOI - PubMed - PMC
    1. Siddiqui MA, Hardy AK, Mercier PA, Farmakis SG (2019) Association between ventricular shunt catheter calcifications and the development of shunt fracture. Pediatr Radiol 49(13):1773–1780. https://doi.org/10.1007/s00247-019-04488-0 - DOI - PubMed
    1. Cakir E, Kuzeyli K, Usul H, Peksoylu B, Karaarslan G, Yildiz K (2004) Shunt dysfunction due to calcification of a ventriculo-peritoneal shunt: a case report. J Clin Neurosci 11(2):210–211. https://doi.org/10.1016/j.jocn.2003.02.012 - DOI - PubMed

LinkOut - more resources