Ventriculosubgaleal shunt in children with hydrocephalus

Abstract

Objective: To determine the rate of conversion to ventriculoperitoneal (VP) shunt in children treated with ventriculosubgaleal (VSG) shunt for hydrocephalus of infective and noninfective etiology. Materials and Methods: A prospective, observational study was conducted at the department of neurosurgery in a tertiary care medical institute in children who underwent VSG shunt for congenital and acquired hydrocephalus of infective and noninfective etiology. Primary outcome measure was rate of conversion to VP shunt. Results: In total 58 children, 65.5% were aged 5 days to 12 months and 67.2% were male. Meningitis (70.7%) was the most common cause of hydrocephalus, followed by hemorrhage (20.7%) and congenital causes (8.6%). The rate of conversion to VP shunt was 58.6%. Moreover, 25.9% of the children had spontaneous resolution of hydrocephalus with no further requirement of shunt, whereas 15.5% required endoscopic third ventriculostomy. Shunt revision was required in 6.9% of the children and shunt malfunction rate was 5.2%. Other complications such as cerebrospinal fluid (CSF) leak (3.4%), wound infection (1.7%), and shunt tip migration (1.7%) were uncommon. Conclusion: VSG shunt is a simple and effective treatment for temporary diversion of CSF for infective and noninfective hydrocephalus in children who are not ideal for a permanent method of CSF diversion even in the presence of active meningitis and shunt infection. In experienced hands and in selected cases, VSG shunt alone can help resolve the hydrocephalus.