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Ventricular reservoirs and ventriculoperitoneal shunts for newborn infants with hydrocephalus: An institutional experience

Ali Haydar Turhan

Background: Hydrocephalus is a common condition that leads to progressive ventricular dilatation caused by physical or functional obstruction of cerebral spinal fluid flow. The main treatment for hydrocephalus is surgical.

Objectives: The aim of our study is to present our experience on patients for whom a ventricular reservoir and/or ventriculoperitoneal shunt was placed because of progressive hydrocephalus.

Methods: The record of patients who were born between 2013-2018 and diagnosed with progressive hydrocephalus was reviewed retrospectively. Demographical and clinical characteristics, complications and the need for ventriculoperitoneal shunt were documented.

Results: Among the 68 babies, 25 babies were preterm (median birth weight 2650 g; mean gestational age 36 weeks), 43 babies were determined as term (mean birth weight 3195 g; mean gestational age 39 weeks). The etiology of hydrocephalus was spinal dysraphism in 49 (72%) patients, congenital hydrocephalus in 13 (19.1%) patients, intraventricular hemorrhage in 6 (8.9%) patients. Mean placement time of the reservoir was 27.1 (range 4 – 57) days of birth, while the mean age at which a reservoir was converted to a permanent shunt was 49.4 (20 – 92) days. Ventriculoperitoneal shunt was placed to 66 infants (97.1%). Complications related to the reservoir were skin necrosis in one patient. Five infants (7.4%) died; three of five infants had major cardiac malformation and two of five babies who have anomalies of other systems.

Conclusion: In preterm babies with low birth weights and term infants who have intraventricular hemorrhage VP shunt surgery may not be performed. Ventricular temporary reservoir placement is effective procedure for cerebrospinal fluid drainage in cases of progressive hydrocephalus.