Repeated Malfunction of Shunt Contains Plethora of Surgical Procedures: The Institutional Based Study

Abstract

Objective: To highlight the course of management that patient went through with multiple episodes of shunt failure and its associated morbidity or mortality
Methodology: The patients were included who have repeated shunt failure by highlighting some arbitrary predictors. Patient was not followed but admitted again and again with active hydrocephalus in neurosurgical ward. The exclusion of patients, who have shunt exposed through natural orifices.
Results: Total number of 31 patients were included and mostly 35.5% were less than 1 year & 35.5% were the age >10 and as the age increases, number of procedures also increases and outcome decreases (0.006). The cause of shunt placement was mainly hydrocephalus (61.3%) and 80.6% patients have right sided placement. 51.6% of shunts was performed in 2020 and mostly Indian shunt 83.9%. Surgical procedures include immediate removal of shunt (32.3%), revision of lower end (19.4%), revision of upper end (32.3%), external ventricular drainage (22.6%), endoscopic third ventriculostomy (41.9%), complete shunt revision (35.5%), externalization at lower end (22.6%), externalization at neck (22.6%) and placement of same shunt (25.8%).
Conclusion: The problems that shunt holds not only include over-drainage or under drainage but it also creates ripples of events. Once the malfunction occurs; the sequence continuous to occur besides changing of hardware.
Keywords: Hydrocephalus, Morbidity, Mortality, Shunt revision, Shunt malfunction,