open access

Vol 51, No 1 (2017)
Original research articles
Submitted: 2016-02-04
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Different origins of hydrocephalus lead to different shunt revision rates

Stefanie Kaestner, Manuela Poetschke, Christian Roth, Wolfgang Deinsberger
DOI: 10.1016/j.pjnns.2016.11.007
·
Neurol Neurochir Pol 2017;51(1):72-76.

open access

Vol 51, No 1 (2017)
Original research articles
Submitted: 2016-02-04

Abstract

Introduction

Hydrocephalus (HC) occurs due to multiple origins. Time course and dynamic of HC and its therapies differ between underlying pathologies. Different revision rates due to the type of HC are expected. Though hydrocephalus is known to be a life time condition, the lack of shunt malfunction years or decades after initial shunt insertion raises the hope of a superfluous shunt.

Methods

We conducted a retrospective survey of our OR-database during a 10 year period. All newly inserted shunt systems and subsequent shunt revisions are recorded according to quantity and time point. All patients were subdivided according their aetiology of HC.

Results

260 patients were eligible with a follow-up of 4.5 years. Subgroups were: 90 patients with NPH, 76 patients with posthaemorrhagic and 16 patients had posttraumatic HC. 22 received a shunt as a consequence of a tumour, 41 were children and 15 for other causes. Overall revision rate was 39.5%. During the first 6 months 55.6%, 57.9% and 75% of patients with NPH, posthaemorrhagic and posttraumatic HC had revisions. In contrast only 38.1% of children and 20% of tumour cases required early revision.

Conclusion

Two different patterns of revision are evident: mainly early revisions in morphologically stable diseases such as posthaemorrhagic, posttraumatic and NPH and predominantly late revisions in changing organisms such as children and tumour patients. The conception HC may be transient because of a lack of late revisions cannot be supported by this data.

Abstract

Introduction

Hydrocephalus (HC) occurs due to multiple origins. Time course and dynamic of HC and its therapies differ between underlying pathologies. Different revision rates due to the type of HC are expected. Though hydrocephalus is known to be a life time condition, the lack of shunt malfunction years or decades after initial shunt insertion raises the hope of a superfluous shunt.

Methods

We conducted a retrospective survey of our OR-database during a 10 year period. All newly inserted shunt systems and subsequent shunt revisions are recorded according to quantity and time point. All patients were subdivided according their aetiology of HC.

Results

260 patients were eligible with a follow-up of 4.5 years. Subgroups were: 90 patients with NPH, 76 patients with posthaemorrhagic and 16 patients had posttraumatic HC. 22 received a shunt as a consequence of a tumour, 41 were children and 15 for other causes. Overall revision rate was 39.5%. During the first 6 months 55.6%, 57.9% and 75% of patients with NPH, posthaemorrhagic and posttraumatic HC had revisions. In contrast only 38.1% of children and 20% of tumour cases required early revision.

Conclusion

Two different patterns of revision are evident: mainly early revisions in morphologically stable diseases such as posthaemorrhagic, posttraumatic and NPH and predominantly late revisions in changing organisms such as children and tumour patients. The conception HC may be transient because of a lack of late revisions cannot be supported by this data.

Get Citation

Keywords

Ventriculoperitoneal shunt, Shunt failure, Revision rate

About this article
Title

Different origins of hydrocephalus lead to different shunt revision rates

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 1 (2017)

Pages

72-76

DOI

10.1016/j.pjnns.2016.11.007

Bibliographic record

Neurol Neurochir Pol 2017;51(1):72-76.

Keywords

Ventriculoperitoneal shunt
Shunt failure
Revision rate

Authors

Stefanie Kaestner
Manuela Poetschke
Christian Roth
Wolfgang Deinsberger

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