Management and Outcome Predictors of Pediatric Cerebrospinal Fluid Shunt Infections

Abstract

Background: Hydrocephalus is a condition caused by accumulation of cerebrospinal fluid (CSF) within the cerebral ventricular system, it is commonly seen in neurosurgical practice. The usual cause of the accumulation is obstruction to the flow of CSF or failure to absorb it. The aqueduct and other pathways can be obstructed or obliterated by blood clot or erythrocytes, debris from a necrotic or inflammatory process within the central nervous system (CNS), inflammatory edema from infection, and, occasionally, from intracranial space-occupying lesions.The primary neurosurgical treatment of hydrocephalus involves the surgical insertion of a shunt system which drains the excessive fluid into other body cavities where it can be reabsorbed. Since its introduction in the 1950's, placement of ventriculoperitoneal (VP) shunts has provided a highly efficacious treatment for thousands of hydrocephalus patients annually. Nevertheless, its effectiveness has been overshadowed by complications such as infection and mechanical malfunction.Shunts have several complications; the most common complication of them is its infection, which can be defined simply as the infection which can occur by several organisms along the whole course of the shunting system manifesting itself clinically and can be evaluated by different methods of investigations including laboratory and radiological studies. Shunt infection has much morbidity, especially in the developmental growth of the affected children and enormous economic costs for healthcare systems. The rate of shunt infection varies from 10% to 22%.Copyright © 2022, Anka Publishers. All rights reserved.