Ventriculosubgaleal shunting--a strategy to reduce the incidence of shunt revisions and slit ventricles: an institutional experience and review of the literature.

Journal Article (Review)

BACKGROUND/AIMS: Slit ventricles and multiple episodes of shunt failure are problematic in many infants and preterm neonates shunted for hydrocephalus. We utilized ventriculosubgaleal (VSG) shunting as the initial neurosurgical intervention in neonates with hydrocephalus associated with intraventricular hemorrhage and infants with myelomeningocele. METHODS: We conducted a chart review of 21 children initially treated with a VSG shunt between November 2002 and July 2009. Patient records and imaging studies were reviewed. Demographics, case data and clinical outcome were collected. RESULTS: Five patients (27.8%) required a revision after conversion to a ventriculoperitoneal (VP) shunt. There were 9 cases of radiographic slit ventricles (45%). Average follow-up was 59.5 months (range 12-97 months). Average time interval to shunt conversion was 81.5 days. Two patients have not required conversion to a VP shunt (one with an 8-year follow-up). To date, none of these patients has required a subtemporal window or cranial vault expansion. CONCLUSION: Based on our results, initial management of selected hydrocephalic infants with a VSG shunt may prove to be advantageous in the long run for these children as the number of shunt revisions and the incidence of slit ventricles are significantly less than those reported in the literature.

Full Text

Duke Authors

Cited Authors

  • Petraglia, AL; Moravan, MJ; Dimopoulos, VG; Silberstein, HJ

Published Date

  • January 2011

Published In

Volume / Issue

  • 47 / 2

Start / End Page

  • 99 - 107

PubMed ID

  • 21921577

Electronic International Standard Serial Number (EISSN)

  • 1423-0305

International Standard Serial Number (ISSN)

  • 1016-2291

Digital Object Identifier (DOI)

  • 10.1159/000330539

Language

  • eng