Vp Shunt Fracture

All patients with suspected vp shunt dysfunction should be discussed with neurosurgery.

Vp shunt fracture. Ventriculoperitoneal vp shunts are a device used to shunt cerebrospinal fluid in the treatment of hydrocephalus. In follow up examinations we retrospectively reviewed patients who underwent revision surgery. Peritoneal catheter fractures occur most commonly in the neck the area where the tube is subject to mechanical stress.

The rate of shunt complications 1 month following insertion is 15 rising to 25 after 1 year and reaching 34 after 5 years 39 fig. Evidence based approach to complication prediction and avoidance during shunt surgery vp shunt surgery has a considerable long term complication rate. The shunt tubing is fractured at the level of the upper cervical spine.

Between 2006 and 2016 vp shunt surgery was performed on 1357 pediatric patients in our clinic. 5 6 the typical presentation of a fractured shunt system is usually quite late after initial insertion and it may be marked by the rapid onset of dramatic symptoms such as headache nausea swelling over the shunt tract often in a location over the shunt fracture or it may occur in a more subtle fashion over a longer period of time. As the name suggests a catheter is placed with its tip in the ventricle.

In follow up examinations we retrospectively reviewed patients who underwent revision surgery. The distal tubing is now coiled within the abdomen. Disconnection and fracture are two significant mechanical vp shunt dysfunctions and must be adequately researched and understood even during routine follow ups.

We have discussed the diagnosis and treatment approaches in patients with discontinued disconnected or fractured ventriculoperitoneal vp shunts that caused mechanical dysfunction. A disconnected or fractured shunt may be working and it is not safe to state that the shunt is no longer needed. Frontal radiograph of the cervical spine edge enhanced shows a fracture of the ventriculo peritoneal shunt drainage tube black and white arrows with caudal retraction of the distal fragment.

Between 2006 and 2016 vp shunt surgery was performed on 1357 pediatric patients in our clinic. 28097382 indexed for medline mesh terms. Ventriculoperitoneal vp shunt complications include blockage and infection early and prompt detection of shunt dysfunction is vital as delay can lead to markedly raised intracranial pressure coning and death.