title: Complications of lumboperitoneal shunts.
abstract: OBJECTIVE
  Placement of a lumboperitoneal (LP) shunt is a method for treating communicating hydrocephalus. These shunts can be placed with or without valves. We sought to review the complications associated with the use of LP shunts with the increasing use of horizontal-vertical (HV) valve systems.
  
  
  METHODS
  A retrospective chart review of all patients who received LP shunts at University of California, San Francisco from 1998 to 2005 was performed.
  
  
  RESULTS
  Of the 74 patients identified in this study, 67 underwent LP shunt placement for the first time, and seven patients had revisions of LP shunts that were originally placed at another hospital. There were a total of 44 revisions for the entire group: 27 patients had one revision, 10 patients had two or three revisions, and one patient had five revisions. Obstruction or migration of the peritoneal catheter was the most common reason for revision. The HV valve was responsible for shunt malfunction in nine patients and was the second-most common site of system problems. Overdrainage symptoms were observed in 11 patients, most of whom had LP shunts without any valve. No patients with an HV valve system developed an acquired Chiari malformation. There were three cases of infection, two of which required removal of the LP shunt.
  
  
  CONCLUSIONS
  Overall, the placement of LP shunts for the treatment of communicating hydrocephalus seems to be a safe procedure. Serious complications such as subdural hematoma were not observed. The HV valve was associated with minor complications, but it was effective in reducing the incidence of overdrainage.
authors.affiliation: Department of Neurological Surgery, University of California, San Francisco, San Francisco, California 94143, USA. wangv@neurosurg.ucsf.edu
authors.forename: Vincent Y
authors.initials: VY
authors.lastname: Wang
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Barbaro
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lawton
authors.forename: Lawrence
authors.initials: L
authors.lastname: Pitts
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kunwar
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Parsa
authors.forename: Nalin
authors.initials: N
authors.lastname: Gupta
authors.forename: Michael W
authors.initials: MW
authors.lastname: McDermott
mesh_terms: D000293:Adolescent; D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D002648:Child; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019586:Intracranial Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome