Intraventricular hemorrhage complicating ventricular catheter revision: incidence and effect on shunt survival.

A retrospective study was conducted on 105 pediatric patients who underwent shunt revision between 1986 and 1993 at the Alberta Childrens Hospital (Calgary) to determine the frequency of intraventricular hemorrhage (IVH) with ventricular catheter revision. Ventricular catheter revision was performed 143 times in 74 patients. Intraventricular hemorrhage was noted intra-operatively or on post-operative computed tomographic (CT) scans on 45 occasions for an overall incidence of 31%. IVH was associated with a significantly shorter time (p < 0.0002) to subsequent shunt revision (227.33 +/- 392.24 days) compared to catheter survival when no hemorrhage was noted (735.02 +/- 1,001.11 days). This study raises several important questions about the prevention and management of IVH during shunt revision. It also provides the first published report on the incidence of IVH during shunt revision, thereby setting a standard to which future studies can be compared.