VP shunts – what is the commonest complication?

Whilst a VP shunt is an effective way of draining CSF in hydrocephalus, complications are still a significant problem. We retrospectively analysed charts of 94 children between the years 1993 and 2003 to estimate the common complications. The commonest complication was shunt blockage (30%). This was followed by shunt fractures (4.2%). Infection was 2.2%. When a shunt malfunctions due to blockage, the commonest area of blockage was within the intraventricular component (90%). Most children who presented with shunt blockage needed more than one revision. Overall 44 revisions were carried out in 23 children. Protein levels of CSF did not correlate with frequency of blockage. In an endeavour to establish whether shunt blockage is related to intraventricular catheter position, an analysis is made of the available images. Furthermore, the recent literature in relation to shunt blockage is also reviewed. There were no shunt fractures below the age of three years, and the routine policy of doing an X-ray shunt series should be discouraged in children less than 2 years old with unitised shunts.