title: Preliminary study of shunt related death in paediatric patients.
abstract: Hydrocephalus is a condition commonly encountered in paediatric and adult neurosurgery and cerebrospinal fluid (CSF) shunting remains the treatment of choice for many cases. Despite improvements in shunt technology and technique, morbidity and mortality remain. The incidence of early shunt obstruction is high with later failures seen less frequently. This review aims to examine mortality associated with mechanical failure of CSF shunts within Queensland. Neurosurgical and Intensive Care databases were reviewed for cases of mortality associated with shunt failure. Eight cases were identified between the years of 1992 and 2002 with the average age at death 7.7 years. Deaths occurred on average 2 years after last shunt revision. Seven of the eight patients lived outside the metropolitan area. Shunting remains an imperfect means of treating hydrocephalus. Mortality may be encountered at any time post surgery and delays to surgical intervention influence this. Alternative measures such as third ventriculostomy or the placement of a separate access device should be considered. In the event of emergency, a spinal needle could be used to access the ventricle along the course of the ventricular catheter.
authors.affiliation: Neurosurgery Department, Royal Brisband Hospital, Herston, 4069 Qld., Australia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bryant
authors.forename: J
authors.initials: J
authors.lastname: McEniery
authors.forename: D G
authors.initials: DG
authors.lastname: Walker
authors.forename: R
authors.initials: R
authors.lastname: Campbell
authors.forename: B
authors.initials: B
authors.lastname: Lister
authors.forename: P
authors.initials: P
authors.lastname: Sargent
authors.forename: T K
authors.initials: TK
authors.lastname: Withers
authors.forename: J
authors.initials: J
authors.lastname: Baker
authors.forename: E
authors.initials: E
authors.lastname: Guazzo
authors.forename: R
authors.initials: R
authors.lastname: Rossato
authors.forename: D
authors.initials: D
authors.lastname: Anderson
authors.forename: F
authors.initials: F
authors.lastname: Tomlinson
mesh_terms: D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality* / Q000601:surgery*; D010372:Pediatrics; D012189:Retrospective Studies