Per-operative findings of blocked ventriculoperitoneal shunt: a study of 72 cases.
BACKGROUND
Most patients with hydrocephalus are treated with ventriculo-peritoneal (VP) shunt placement; however, malfunction is common and is usually caused by mechanical failure. The aim of this study was to evaluate the per-operative findings accompanying presumed VP shunt malfunction.


METHODS
This is a descriptive study of 72 patients operated for shunt malfunction in the Department of Neurosurgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from January to December 2008. Presenting symptoms and signs, clinical shunt function, operative findings and outcome were recorded.


RESULTS
Common presenting features were vomiting, irritability and general toxic look of patients. Male to female ratio was 3:1. Upper end block was observed in 39 patients while lower end and reservoir block was noted in 13 and 2 patients respectively. Choroids plexus was found in 29.2% of cases with upper end block, shunt revision was performed in most of cases (80.6%).


CONCLUSIONS
The importance of clinical features cannot be overlooked in a patient with shunt malfunction. Upper end block due to choroids plexus is common operative finding.
Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan. usmanlrhn@yahoo.com
Muhammad Usman
MU
Khan
Mumtaz
M
Ali
Syed Javed
SJ
Hussain
Nadeem
N
Ullah
Khalid
K
Khanzada
Shahid
S
Ayub
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D055815:Young Adult