Complications of ventriculoperitoneal shunts in Benin City, Nigeria

Abstract

Background: In most neurosurgical centres, ventriculoperitoneal shunt (VPS) is a commonly performed neurosurgical procedure for cerebrospinal fluid (CSF) diversion in Hydrocephalus in children, especially, but also in adults though etiology may differ. Despite the advent of other CSF diversionary procedures, like endoscopic third ventriculostomy, VPS has remained the mainstay of the treatment for Hydrocephalus. However, it is fraught with several complications.

Objective/Purpose of Study: To highlight the setbacks plaguing a common and relatively short neurosurgical procedure

Methods: This was a retrospective study on all 110 patients who presented at our Teaching Hospital with clinical and radiological features of hydrocephalus over a 60-month period between January 1, 2010, and December 31, 2014.

Results: A total of 139 procedures were carried out in 110 patients. There were 64 males and 46 females, a ratio of 1.4: 1. Most patients, 73 i.e. 66.4%, had Congenital Hydrocephalus. Hydrocephalus was secondary to tumors in 21 patients (19.1%) and meningitis in 14 patients (12.7%). One patient had traumatic subarachnoid hemorrhage. Shunt failures were seen in 23 patients (20.9%); causes of failure included shunt malfunction (56.5%), infection (21.7%), overdrainage (13.0%) and shunt migration (8.7%).

Conclusions: Successful treatment of VPS complications depends on early diagnosis and a high index of suspicion. Any features of sepsis or other symptoms referable to central nervous system in patients who have undergone VPS insertion should warrant thorough clinical, radiological and laboratory screening for shunt complications.

Keywords: Ventriculoperitoneal Shunt; Cerebrospinal Fluid Diversion; Hydrocephalus; Complications; Mainstay; Index of Suspicion.