Ventriculosinus shunt as a reliable option in the treatment of failed ventriculoperitoneal shunt: report of 19 cases and review of the literature.

BACKGROUND

The authors of this study aim to summarize their experience with lateral ventriculosinus shunt in the treatment of hydrocephalus patients and assess its clinical value.

METHODS

Ventriculoperitoneal shunt was performed but failed due to obstruction and infection of the shunt. Lateral ventriculosinus shunt was inserted in 19 hydrocephalus patients by a Medtronic programmable shunt valve. All 19 patients suffered from either an obstruction or infection after ventriculoperitoneal shunting, while 11 cases had a peritoneal obstruction, 8 cases had an intracranial infection, and 1 case had an intra-abdominal infection. Among the 19 cases, there were 2 cases with obstructive hydrocephalus and 17 cases with communicating hydrocephalus.

RESULTS

All clinical symptoms of 9 patients disappeared completely, while for 8 patients, noticeable improvement was accomplished, and only 2 patients showed no improvement. All 19 cases were followed up for 6 to 60 months. During the follow-up period, in 17 patients the shunt remained effective, while 2 cases underwent removal of the shunt due to low preoperative intracranial pressure and no significant changes in postoperative symptoms and ventricular size. During follow-up there was no thrombosis in the sagittal sinus, and no infection, over drainage, intracranial hemorrhage, or subdural effusion occurred.

CONCLUSIONS

We demonstrate that lateral ventriculosinus shunt is a reliable option for failed ventriculoperitoneal shunt hydrocephalus patients. Nevertheless, the effectiveness and possible complications of this method need further confirmation by observation in a study with a larger cohort.