title: Management of adult hydrocephalus with ventriculoperitoneal shunts: long-term single-institution experience.
abstract: BACKGROUND
  Ventriculoperitoneal shunting is the most widely used neurosurgical procedure for the management of hydrocephalus.
  
  
  OBJECTIVE
  To evaluate our long-term single-institution experience in the management of adult hydrocephalus patients with ventriculoperitoneal shunts.
  
  
  METHODS
  Adult patients who underwent ventriculoperitoneal shunt placement for hydrocephalus from October 1990 to October 2009 were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively for clinical outcome in adult hydrocephalus patients.
  
  
  RESULTS
  A total of 683 adult patients were included in the study. The most common etiologies of hydrocephalus include idiopathic (29%), tumors and cysts (20%), postcraniotomy (13%), and subarachnoid hemorrhage (13%). The overall shunt failure rate was 32%, and the majority (74%) of shunt revisions occurred within the first 6 months. The median time to first shunt revision was 9.31 months. Etiology of hydrocephalus showed a significant impact on the incidence of shunt revision/failure and on the median time to shunt revision. Similarly, the type of hydrocephalus had a significant effect on the incidence of shunt failure and the median time to shunt revision.
  
  
  CONCLUSIONS
  A large proportion of patients (32%) experience shunt failure after shunt placement for hydrocephalus. Although the overall incidence of shunt revision was comparable to previously reported studies, the fact that a large proportion of adult populations with shunt placement experience shunt failure is a concern.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, USA. kreddy_usa@yahoo.com
authors.forename: G Kesava
authors.initials: GK
authors.lastname: Reddy
authors.forename: Papireddy
authors.initials: P
authors.lastname: Bollam
authors.forename: Runhua
authors.initials: R
authors.lastname: Shi
authors.forename: Bharat
authors.initials: B
authors.lastname: Guthikonda
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000328:Adult; D004868:Equipment Failure / Q000706:statistics & numerical data*; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects