Cerebrospinal Fluid Shunt Complications

Abstract

The purpose of this study is to determine the incidence of different shunt complications and whether there is any significant statistical correlation between the complications and the cause of shunt insertion, the period of shunt insertion, cerebrospinal fluid characteristics, symptoms and signs, preoperative and postoperative diagnoses, and shunt type (low-, medium-, or high-pressure valve shunts). This cross-sectional study covers 95 patients with hydrocephalus after shunt insertion who had been admitted due to shunt complication in neurosurgery wards of Qaem and Emdadi Hospitals (Mashad, Iran) from March 1992 to March 2002. We studied the sex, age, origin and period of shunt insertion, preoperative and postoperative diagnoses, cerebrospinal fluid characteristics, symptoms and signs, and shunt type (on the axiom of valve pressure). All the data were analyzed using Statistical Package for Social Sciences (SPSS) release 11.5 software and chi square, Kruskal-Wallis, t-test, and nonparametric statistical tests. The results observed in our patients indicated that obstruction was the most common shunt complication (44.2%). Among the different mechanical causes of shunt failure, obstruction and disconnection were the most common causes respectively. The incidence of shunt complication is affected by the cause of shunt insertion. Cerebrospinal fluid culture had a 50% sensitivity to suggest shunt infection. The most common symptom(s) and sign were headache, nausea, and/or emesis and decreased levels of consciousness.