title: Shortening of ventricular shunt catheter associated with cranial growth: effect of the frontal and parieto-occipital access route on long-term shunt patency.
abstract: OBJECTIVE
  The authors present the difference of shortening the ventricular shunt catheter associated with growth of the cranium between the frontal and parieto-occipital access, a key for long patency of the shunt implanted in children.
  
  
  METHODS
  Our retrospective study included 28 children. In group A (n=9), the catheter was inserted through a frontal burr hole and in group B (n=19), through a parieto-occipital burr hole. To compare changes that occurred in the interval between the time of insertion and follow-up in the length of the ventricular catheter in the cranium and to assess displacement of the burr used for catheter entry.
  
  
  RESULTS
  The results show that ventricular catheter shortening and burr-hole displacement were more pronounced in group A.
  
  
  CONCLUSIONS
  This study documents that insertion of the ventricular catheter via the frontal route in children resulted in a higher incidence of shortening due to greater displacement of the burr hole adjacent to the coronal suture. Therefore, we recommend that the parieto-occipital route be used to maintain long-term shunt function.
authors.affiliation: Department of Neurosurgery and Radiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan. nakahara19@hotmail.com
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Nakahara
authors.forename: Satoru
authors.initials: S
authors.lastname: Shimizu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Utsuki
authors.forename: Sachio
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Oka
authors.forename: Masaru
authors.initials: M
authors.lastname: Yamada
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kan
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fujii