Reviewing Hydrocephalus: Personal experience of a Neurosurgeon with Ventriculoperitoneal shunts treatment

  • Authors

    • Vinod Kumar Singh Gautam IHBAS, Delhi, India
    • Ravinder Singh
    • Sarbjeet Khurana
    2014-08-25
    https://doi.org/10.14419/ijm.v2i2.3219

  • Abstract

    Background: Hydrocephalus is one of the most common neurologic sequelae following insult to the central nervous system. The treatment of hydrocephalus is very challenging. Ventriculoperitoneal shunt surgery is the commonest form of CSF diversion procedure for hydrocephalus. The objective of this study is to look critically at the efficacy of this procedure and compare the outcome with other studies involving different therapeutic options for treating hydrocephalus.

    Material & Methods: Fourty three patients of hydrocephalus who were operated for ventriculoperitoneal shunt placement were included in the study. Review of medical records including operative notes, imaging studies and clinic-radiological follow up of all the patients were reviewed and analyzed.

    Results: The common etiologies include post meningitic hydrocephalus, congenital hydrocephalus, NPH, posterior fossa tuberculomas, neurocysticercosis and posterior fossa tumor. Right sided ventriculoperitoneal shunt with medium pressure valve system was the commonest modality of treatment. None of the patients had any incidence of shunt infection.

    Conclusion: The results of this retrospective study show that ventriculoperitoneal shunting is effective in the management of adult patients with obstructive hydrocephalus. The overall incidence of shunt revision was comparable with previously reported studies in the literature.

    Keywords: Hydrocephalus, Ventriculoperitoneal Shunt.

  • References

    1. Robertson J.S., Maraqa M.I., Jennett Bryan: Ventriculopperitoneal shunting for hydrocephalus. British Medical Journal, 1973, 2, 289-292. http://dx.doi.org/10.1136/bmj.2.5861.289.
    2. Low D, Drake JM, Seow WT, Ng WH. Management of ventriculo-peritoneal shunts in the paediatric population. Asian J Neurosurg. 2010 Jan; 5(1):7-14.
    3. Jha R, Khadka N, Kumar P.Management of Hydrocephalus – Our Experience. PMJN, Vol 10, Number 2, Jul-Dec 2010, 68-70.
    4. Dandy W E. Diagnosis and treatment of strictures of the aqueduct of Sylvius (causing hydrocephalus). Arch Surg 1945; 51:1-14. http://dx.doi.org/10.1001/archsurg.1945.01230040004001.
    5. Mixter WJ. Ventriculoscopy and puncture of the floor of the third ventricle. Boston Med Surg J 1923; 188:277-278. http://dx.doi.org/10.1056/NEJM192303011880909.
    6. Hadenius AM, Hagberg B, Hyttnäs-Bensch K, Sjögren I. Congenital hydrocephalus. II. Long-term prognosis of untreated hydrocephalus in infants. Nord Med 1962; 68:1515-9.
    7. Ali M, Usman M, Khan Z, Khan K.M.,Hussain R,and Khanzada K: Endoscopic third ventriculostomy for obstructive hydrocephalus. Journal of the College of Physicians and Surgeons, Pakistan 2013, Vol. 23(5): 338-341.
    8. Weninger M, Salzer HR, Pollak A, Rosenkranz M, Vorkapic P, Korn A, Lesigang C. External ventricular drainage for treatment of rapidly progressive posthemorrhagic hydrocephalus. Neurosurgery. 1992 Jul; 31(1):52-7; discussion 57-8. http://dx.doi.org/10.1227/00006123-199207000-00008.
    9. Reddy G., Shi R, and Nanda A., Guthikonda B. Obstructive hydrocephalus in adult patients: the Lousiana State University Health Sciences Center- Shreveport experience with ventriculoperitoneal shunts. Clin Neurol Neurosurg. 2012 Nov; 114(9):1211-6. http://dx.doi.org/10.1016/j.clineuro.2012.02.050.
    10. Eva -Karin Persson (2007) Hydrocephalus In Children Epidemiology and outcome. Published Thesis. Göteborg University Sweden Göteborg ISBN 978-91-628-7050-8 https://gupea.ub.gu.se
    11. Poca MA, Sahuquillo J. Short-term medical management of hydrocephalus. Expert Opin Pharmacother. 2005 Aug; 6(9):1525-38. http://dx.doi.org/10.1517/14656566.6.9.1525.
    12. Hamilton MG. Treatment of hydrocephalus in adults.Semin Pediatr Neurol. Mar 2009; 16(1):34-41. http://dx.doi.org/10.1016/j.spen.2009.02.001.
    13. Reddy GK, Bollam P, Shi R, Guthikonda B, Nanda A. Management of adult hydrocephalus with ventriculoperitoneal shunts: long-term single-institution experience. Neurosurgery. 2011 Oct; 69(4):774-80. http://dx.doi.org/10.1227/NEU.0b013e31821ffa9e.
    14. Maurice Choux, Lorenzo Genitori, Dorothy Lang, and Gabriel Lena. Shunt implantation: reducing the incidence of shunt infection. Journal of Neurosurgery 1992; 77:6, 875-880 http://dx.doi.org/10.3171/jns.1992.77.6.0875.
    15. Rehman AU, Rehman TU, Bashir HH, Gupta V. A simple method to reduce infection of ventriculoperitoneal shunts. J Neurosurg Pediatr. 2010 Jun; 5(6):569-72 http://dx.doi.org/10.3171/2010.2.PEDS09151.

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  • How to Cite

    Gautam, V. K. S., Singh, R., & Khurana, S. (2014). Reviewing Hydrocephalus: Personal experience of a Neurosurgeon with Ventriculoperitoneal shunts treatment. International Journal of Medicine, 2(2), 56-59. https://doi.org/10.14419/ijm.v2i2.3219

    Received date: 2014-07-22

    Accepted date: 2014-08-20

    Published date: 2014-08-25