Ventriculo-peritoneal shunt obstructions in the absence of radiological abnormalities: retrospective analysis of a pediatric cohort

Abstract

Introduction: Ventriculoperitoneal shunts are still the mainstay treatment for pediatric hydrocephalus. They have a high complication and failure rate, requiring multiple revisions. In this study, we aim to investigate patients who required shunt replacement without any radiological findings. Methods: The files of patients under the age of 18, who underwent shunt revision between December 2015 and December 2020 in Bursa Uludag University Medical Faculty Neurosurgery clinic were reviewed retrospectively. All the radiological studies, laboratory results and clinical condition of the patients were examined. Results: We identified 127 patients who required a revision of ventriculoperitoneal shunt for suspected mechanical obstruction. 6 patients (5%) had symptoms of raised intracranial pressure, but showed no radiographic evidence of progressive ventricular dilatation. Conclusion: Dysfunction of a ventriculoperitoneal shunt does not always lead to associated radiological alterations. In a patient with signs of intracranial hypertension, revision of the system should be considered even in the absence of progressive ventricular dilatation on radiological studies.