Shortening of ventricular shunt catheter associated with cranial growth: effect of the frontal and parieto-occipital access route on long-term shunt patency

Childs Nerv Syst. 2009 Jan;25(1):91-4. doi: 10.1007/s00381-008-0709-2. Epub 2008 Sep 4.

Abstract

Object: The authors present the difference of shortening the ventricular shunt catheter associated with growth of the cranium between the frontal and parieto-occipital access, a key for long patency of the shunt implanted in children.

Materials and method: Our retrospective study included 28 children. In group A (n=9), the catheter was inserted through a frontal burr hole and in group B (n=19), through a parieto-occipital burr hole. To compare changes that occurred in the interval between the time of insertion and follow-up in the length of the ventricular catheter in the cranium and to assess displacement of the burr used for catheter entry.

Results: The results show that ventricular catheter shortening and burr-hole displacement were more pronounced in group A.

Conclusions: This study documents that insertion of the ventricular catheter via the frontal route in children resulted in a higher incidence of shortening due to greater displacement of the burr hole adjacent to the coronal suture. Therefore, we recommend that the parieto-occipital route be used to maintain long-term shunt function.

MeSH terms

  • Catheterization / adverse effects
  • Catheterization / methods*
  • Cerebrospinal Fluid Shunts / adverse effects
  • Cerebrospinal Fluid Shunts / instrumentation
  • Cerebrospinal Fluid Shunts / methods*
  • Frontal Bone / diagnostic imaging
  • Frontal Bone / surgery
  • Humans
  • Hydrocephalus / surgery*
  • Infant
  • Infant, Newborn
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / surgery
  • Parietal Bone / diagnostic imaging
  • Parietal Bone / surgery
  • Prostheses and Implants
  • Retrospective Studies
  • Skull / surgery
  • Stereotaxic Techniques
  • Time Factors
  • Tomography, X-Ray Computed
  • Ventriculoperitoneal Shunt / adverse effects
  • Ventriculoperitoneal Shunt / methods