title: Cerebrospinal Fluid Shunting Complications in Children.
abstract: Although cerebrospinal fluid (CSF) shunt placement is the most common procedure performed by pediatric neurosurgeons, shunts remain among the most failure-prone life-sustaining medical devices implanted in modern medical practice. This article provides an overview of the mechanisms of CSF shunt failure for the 3 most commonly employed definitive CSF shunts in the practice of pediatric neurosurgery: ventriculoperitoneal, ventriculopleural, and ventriculoatrial. The text has been partitioned into the broad modes of shunt failure: obstruction, infection, mechanical shunt failure, overdrainage, and distal catheter site-specific failures. Clinical management strategies for the various modes of shunt failure are discussed as are research efforts directed towards reducing shunt complication rates. As it is unlikely that CSF shunting will become an obsolete procedure in the foreseeable future, it is incumbent on the pediatric neurosurgery community to maintain focused efforts to improve our understanding of and management strategies for shunt failure and shunt-related morbidity.
authors.affiliation: Department of Neurological Surgery, University of Washington and Seattle Children's Hospital, Seattle, WA, USA.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Hanak
authors.forename: Robert H
authors.initials: RH
authors.lastname: Bonow
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Harris
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Browd
mesh_terms: D057785:Catheters / Q000009:adverse effects; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects* / Q000295:instrumentation; D004868:Equipment Failure; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery* / Q000628:therapy*; D000069471:Neurosurgeons; D010372:Pediatrics; D011183:Postoperative Complications; D019736:Prostheses and Implants
keywords: Catheter obstruction; Hydrocephalus; Shunt failure; Ventriculoatrial shunt; Ventriculoperitoneal shunt; Ventriculopleural shunt