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Randomized Controlled Trial
. 2024 Jun;40(6):1771-1776.
doi: 10.1007/s00381-024-06344-5. Epub 2024 Mar 5.

Comparative study between ventriculosubgaleal shunt and external ventricular drain for management of post infective hydrocephalus among pediatrics

Abdelaziz Abdelhamid Ismail  1 , Ahmed Nageeb Taha  2 , Hatem Ibraheem Badr  2 , Ahmed Zaher  2 , Samy Abbas Elbaz  3 , Amr Farid Khalil  2
Affiliations
Randomized Controlled Trial

Comparative study between ventriculosubgaleal shunt and external ventricular drain for management of post infective hydrocephalus among pediatrics

Abdelaziz Abdelhamid Ismail et al. Childs Nerv Syst. 2024 Jun.

Abstract

Purpose: Post infective hydrocephalus (PIH) is a type of hydrocephalus which occurs after an infection of the brain or cerebrospinal fluid (CSF). Treatment of PIH requires temporary measures such as external ventricular drain (EVD) and ventriculosubgaleal shunt (VSGS) until CSF becomes clear and ready to implement VP shunt. Limited research has been done to explore the tradeoff between these approaches particularly in pediatric PIH patients. Our study compares the complications, mortality rates, and the cost of used resources of both procedures.

Methods: A prospective study was conducted for 18 months in which we compared between VSGS and EVD for management of PIH involving 42 randomized cases with 21 patients in group A operated by VSGS and 21 patients in group B operated by EVD.

Results: Our results show a statistically significant difference between both groups in the duration of implementation of VSGS/EVD until resolution of infection occurs. Additionally, a higher rate of pediatric intensive care unit (PICU) admission and a longer length of hospital stay (LOS) were recorded among the EVD group. No statistically significant difference between the number of complications that happened in both despite variations in their forms. Moreover, both groups showed nearly similar mortality rates.

Conclusion: There is no significant difference in the rate of complications between VSGS and EVD for PIH. Based on that, VSGS emerges as a favorable and cost-effective option for the management of PIH which leads to less economic burden on patients and the country's health resources, especially in developing countries.

Keywords: External ventricular drain; Intracranial pressure; Meningitis; Post infective hydrocephalus; Ventriculosubgaleal shunt.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
16-month-old infant with VPS infection and hydrocephalus
Fig. 2
Fig. 2
16-month-old infant after removing VPS and insertion of VSGS
See this image and copyright information in PMC

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