[Complications of cerebrospinal fluid shunt].
OBJECTIVE
The objective of this study was to know the incidence, mode of presentation, clinical and microbiological aspects, as well as the management of ventriculo-peritoneal shunt malfunction.


METHODS
A retrospective study was carried out where thirty-seven children with malfunctioning shunts were studied. The mechanical causes of shunt malfunction included disconnection, fracture and obstruction, while infection was considered as either a clinical or analytical change (blood and/or CSF).


RESULTS
The mean age of the patients was 5.5 years. The most common indication for the insertion of the ventriculoperitoneal shunt was congenital hydrocephalus. The average stay in the ICU was 8.2 days. Mechanical dysfunction was detected in 25 patients (68%) and infectious etiology in 12. The most common clinical manifestations were vomiting, fever and headache. CSF biochemical alteration was found in 8 of the infected group. Staphylococcus was isolated in six of the 8 cases. The ventriculoperitoneal shunt was changed during the first 24 hours in 17 of 25 patients (68%) with mechanical malfunction, while 11 cases with an infective cause (92%) were managed with an external shunt. The interval between the insertion of the ventriculoperitoneal shunt and the malfunction was over 6 months in 20 cases (54%).


CONCLUSIONS
Ventriculoperitoneal shunts are the main method for treating hydrocephaly, although they are not without complications which may require surgical procedures. Appropriate surgical technique, asepsis, as well as prophylactic antibiotics are essential to decrease the incidence of complications.
Gómez López
L
L
Servicio de Pediatría, Unitat Integrada Hospital Clínic-Sant Joan de Déu, Universitat de Barcelona.
Luaces Cubells
C
C
Costa Clará
J M
JM
Palá Calvo
M T
MT
Martín Rodrigo
J M
JM
Palomeque Rico
A
A
Pou Fernández
J
J
D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000628:therapy; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt
Complicaciones de las válvulas de derivación de líquido cefalorraquídeo.