title: Ventriculoperitoneal shunt dislodgement after a haircut with hair clippers in two shunted boys.
abstract: BACKGROUND
  Hair clippers are widely used to cut hair short at the occipital region for Asian school boys. A haircut as the cause of shunt dislodgement has not previously been reported.
  
  
  METHODS
  Two previously shunted boys presented with shunt dysfunction 1 to 2 days after a haircut during which hair clippers were used at the occipital region. Both of them have undergone shunt utilizing a three-piece system. During the operation, the distal catheter was found to be disconnected from the reservoir at the connector site in both patients. One patient recalled that he had felt pain and then heard a crack when the connector site of the reservoir was dislodged from the distal catheter at the postauricular region. Their ages at the time were 10 and 11 years, respectively. During the time period between this revision and the previous surgery, the patients exhibited increases in body height of 32 and 52 cm, respectively.
  
  
  CONCLUSIONS
  We propose that when children are growing rapidly, the distal catheter is subjected to traction at the site of its connection with the reservoir. A haircut that includes the use of clippers at the occipital region causes a rapid increase in the shearing strain at the shunt connector site that may further stretch the shunt and induce shunt disconnection. Nurses and physicians must address the need to prevent shunt dislodgement caused by haircuts with clippers in young, rapidly growing, male patients who require shunts. A two- or one-piece shunt may prevent this complication.
authors.affiliation: Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. mfkenator@gmail.com
authors.forename: Meng-Fai
authors.initials: MF
authors.lastname: Kuo
authors.forename: Huei-Shyong
authors.initials: HS
authors.lastname: Wang
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Yang
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000254:growth & development / Q000601:surgery; D002648:Child; D004581:Electronics; D004868:Equipment Failure; D006197:Hair; D006801:Humans; D008297:Male; D009777:Occipital Bone; D011860:Radiography, Abdominal; D012886:Skull / Q000000981:diagnostic imaging / Q000254:growth & development / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt