A Clinical Audit: Ventriculoperitoneal Shunt for Patients with Hydrocephalus

Abstract

Purpose: Hydrocephalus, abnormal accumulation of CSF in the ventricles, is one of the most common diseases of the brain. Ventriculoperitoneal shunting is one of the commonest procedures for management of hydrocephalus. Assessment and evaluation of the clinical outcome, following VP shunt, should be carried out to decrease rates of complications of this procedure. Clinical audit plays a vital role in identifying and developing effective methods for improving patient care. This paper sheds light on 37 neurosurgical patients with hydrocephalus who underwent ventriculoperitoneal shunt surgery. Our aim was to identify defects in steps in management of hydrocephalus by VP shunt from time of admission to discharge. Methodology: In this audit study 37 patients with hydrocephalus were selected between November, 2021 and December, 2022 at West Erbil emergency hospital and Erbil teaching hospital. VP shunt surgery was performed for them. Information was gathered from patient records, diagnostic imaging, and operation notes, and subsequent clinical follow-up evaluations were carefully analyzed and reviewed. The gathered data encompassed demographic details, clinical manifestations, radiological studies, reasons for surgery, operative findings, and complications associated with the shunt. Findings: The prevalent causes observed were congenital hydrocephalus (45.9%), posterior fossa tumors (13.5%), and post meningitis hydrocephalus (18.9%). A right-sided VP shunt utilizing a medium-pressure valve system emerged as the most prevalent treatment modality. Three patients exhibited symptoms and signs indicative of shunt infection. Additionally, one patient experienced an epidural hematoma at the site of the burr hole. Unique contribution to theory, practice and policy: Patients with hydrocephalus and undergoing VP shunt surgery should be evaluated carefully and every step from time of admission to discharge is crucial in decreasing the complications which are associated with this surgery.