title: Ventriculoperitoneal shunt surgery outcome in adult transition patients with pediatric-onset hydrocephalus.
abstract: BACKGROUND
  Ventriculoperitoneal shunting remains the most widely used neurosurgical procedure for the management of hydrocephalus, albeit with many complications.
  
  
  OBJECTIVE
  To review and assess the long-term clinical outcome of ventriculoperitoneal shunt surgery in adult transition patients with pediatric-onset hydrocephalus.
  
  
  METHODS
  Patients 17 years or older who underwent ventriculoperitoneal shunt placement for hydrocephalus during their pediatric years (younger than 17 years) were included. Medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retrospectively.
  
  
  RESULTS
  A total of 105 adult patients with pediatric-onset hydrocephalus were included. The median age of the patients was 25.9 years. The median age at the time of the initial ventriculoperitoneal shunt placement was 1.0 year. The median follow-up time for all patients was 17.7 years. The incidence of shunt failure at 6 months was 15.2%, and the overall incidence of shunt failure was 82.9%. Single shunt revision occurred in 26.7% of the patients, and 56.2% had multiple shunt revisions. The cause of hydrocephalus was significantly associated with shunt survival for patients who had shunt failure before the age of 17 years. Being pediatric at first shunt revision, infection, proximal shunt complication, and other causes were independently associated with multiple shunt failures.
  
  
  CONCLUSIONS
  The findings of this retrospective study show that the long-term ventriculoperitoneal shunt survival remains low in adult transition patients with pediatric-onset hydrocephalus.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71103-33932, 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: Gloria
authors.initials: G
authors.lastname: Caldito
authors.forename: Bharat
authors.initials: B
authors.lastname: Guthikonda
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*; D055815:Young Adult