LECTURE NOTES FROM MR CHUMAS

HYDROCEPHALUS AND INSERTION

OF V.P. SHUNTS

Hydrocephalus and Insertion of V.P. Shunts

Intraventricular dilation describedby Volpe in USA grades 1-111.

Hydrocephalus develops 1-3 weeks after intraventricular

haemorrhage.

L/P dry taps – 9% infection rate.

Secondary white matter damage with increasing

hydrocephalus.

Hydrocephalus and Insertion of V.P. Shunts

< 2 kg - Insertion of access device. > 2 kg - Medium pressure shunt. Post Op Shunt – sit in a car seat. Neo-nates Average Infection 2—25% GOS. LGI 5% infection rate, Fifompicin

50 days

Hydrocephalus and Insertion of V.P. Shunts

Increase infection with prematurity.

Double glove-prevention.

Mortality rate doubles with shunt infection.

42% surgical instrument infection –

not the patient.

Hydrocephalus and Insertion of V.P. Shunts

Extra ventricular drainage system.

Leakage.

Catheter tubes antibiotic impregnated, anti-slime.

Hydrocephalus and Insertion of V.P. Shunts

In one year – 40% V.P. Shunts fail

- 10% infection

Shunts – cheapest most practical.