title: Influence of congenital central nervous system malformations on postoperative complications following placement of cerebrospinal fluid shunts in pediatric and adolescent patients.
abstract: BACKGROUND
  This retrospective study was designed to evaluate whether patients with hydrocephalus associated with central nervous system (CNS) anomalies, compared with patients with hydrocephalus and absent CNS anomalies, present with significantly higher rate of postoperative complications, including more serious clinical presentation, increased life threat, and higher postoperative or late mortality rate.
  
  
  METHODS
  We performed a retrospective study using medical records of 100 patients of pediatric and adolescent age (0-18 years) between 2004 and 2010 treated with operative cerebrospinal fluid (CSF) shunt placement.
  
  
  RESULTS
  In both groups of patients, there were 43 postoperative complications, including 12 mechanical obstructions of the CSF drainage systems, 13 disconnections, 11 dislocations of proximal catheter, 6 inflammatory complications (meningitis), and 1 latex allergy. Patients with hydrocephalus associated with CNS anomalies were presented with statistically higher rate of postoperative complications (U = 303.5, z = -3.27, p = 0.001), higher number of operations, at least one complication more per patient, more complicated clinical course, higher life threat, and higher late mortality rate.
  
  
  CONCLUSIONS
  After installing the CSF drain system, children and adolescents with hydrocephalus associated with anomalies of the CNS require regular and careful follow-up.
authors.affiliation: University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia.
authors.forename: Marina
authors.initials: M
authors.lastname: Raguz
authors.forename: Nikolina
authors.initials: N
authors.lastname: Brcina
authors.forename: Davor
authors.initials: D
authors.lastname: Marinac
authors.forename: Miroslav
authors.initials: M
authors.lastname: Gjurasin
mesh_terms: D000293:Adolescent; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000209:etiology* / Q000517:prevention & control; D009421:Nervous System Malformations / Q000150:complications* / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D011379:Prognosis; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome