Ventriculoperitoneal (VP) shunt survival in patients developing hydrocephalus After cranial surgery.

Farid Khan, Aga Khan University
Abdul Rehman Alvi, Aga Khan University
Muhammad Shahzad Shamim, Aga Khan University
Muhammad Ehsan Bari, Aga Khan University

Abstract

Abstract

AIM:

Ventriculoperitoneal (VP) shunt insertion remains the most popular method for the treatment of hydrocephalus despite its associated complications. We assessed VP shunt survival in a group of patients who had developed hydrocephalus following cranialsurgery.

MATERIAL AND METHODS:

A retrospective charts review was done over a 10-year period at our institution. Kaplan-Meier survival curves and Log-Rank (Cox-Mantel) test were used to analyze various factors affecting VP shunt survival.

RESULTS:

Among the 67 cases included, a total of 28 (46.3%) patients had undergone cranial surgery for brain tumors. The overall rate of shunt failure was 14.9% at a mean follow-up of 16 months. Shunt failure in pediatric patients (20%) was slightly higher than that in adult patients (13.5%). The median time to first shunt failure was adversely influenced by a history of brain tumor (p = 0.019), prolonged antibiotic therapy (p = 0.018) and administration of steroids (p = 0.004).

CONCLUSION:

Shunt survival was worse in patients who developed hydrocephalus following cranial surgery performed for brain tumors and those who received either steroids or prolonged antibiotic therapy. Thus post-cranial surgery hydrocephalus represents a unique subset of hydrocephalus.