Abstract
Introduction: Hydrocephalus is the pathology most frequently addressed and studied in pediatric neurosurgery. Over 15,000 new cases are diagnosed each year. Although it is the most com-mon procedure performed by pediatric neurosurgeons, the shunt implant for drainage of cerebrospinal fluid (CSF) also presents the highest rate of failure and replenishment. The last 50 years have been marked by important advances in quality of these implants. How-ever, little has changed regarding the prevalence of these failures. We will comment here the main mechanical failures of the shunt: disconnection, migration, fracture and scrap-ing of the catheter, hollow visceral perforation and distal catheter knot. Methods: Literature review about the main causes of mechanical failure in shunts Conclusion: Shunt dysfunction is still very common, despite technological advances in the treatment of hydrocephalus. Mechanical causes of shunt dysfunction correspond to about 30% of the reasons for changing or overhauling valves. Most of these occur due to surgical problems. Therefore, safe measures reduces these events their clinical features.
Highlights
Hydrocephalus is the pathology most frequently addressed and studied in pediatric neurosurgery
Hydrocephalus is a complex pathology, with several manifestations related to different etiologies, such as congenital malformations, trauma, tumors, infection and hemorrhage
The cause of hydrocephalus is proven to be a statistical factor for ventricular shunt dysfunction [4]
Summary
The history of hydrocephalus treatment with valves evolved very little until the 1960s. Pediatric and adolescent patients with hydrocephalus associated with CNS development abnormalities, present a higher risk of complications after CSF drainage surgery, compared to patients without CNS related abnormalities [3,9,10]. Those with CNS disorders show a higher risk of life, with a more severe clinical presentation. As the improvements in the derivation project seem very limited, there was incentive and space for studies on endoscopic treat-ment Today, undoubtedly, this technique is the great hope and revolution in the treatment of most cases of hydrocephalus. No relevant differences were found in the failure rates of these and other less complex systems [6,7,8]
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