References | VP Shunts

<< Ventriculoperitoneal Shunt Complications In Children: An Evidence-Based Approach To Emergency Department Management


TOC Will Appear Here



Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study, such as the type of study and the number of patients in the study are included in bold type following the references, where available. The most informative references cited in this paper, as determined by the authors, are noted by an asterisk (*) next to the number of the reference.

  1. Thompson DN. Hydrocephalus. Surgery. 2007;25(12):522-525. (Review article)
  2. Baru JS, Bloom DA, Muraszko K, et al. John Holter’s shunt. J Am Coll Surg. 2001;192(1):79-85. (Review article)
  3. Pople IK. Hydrocephaus and shunts: what the neurologist should know. J Neurol Neurosurg Psychiatry. 2002;73:i17-i22. (Review article)
  4. Wu Y, Green NL, Wrensch MR, et al. Ventriculoperitoneal shunt complications in California: 1990 to 2000. Neurosurgery. 2007;61(3):557-562. (Retrospective study; 14,455 patients)
  5. Lee P, DiPatri AJ Jr. Evaluation of suspected cerebrospinal fluid shunt complications in children. Clin Pediatr Emerg Med. 2008;9(2):76-82. (Review article)
  6. Bragg CL, Edwards-Beckett J, Eckle N, et al. Ventriculoperitoneal shunt dysfunction and constipation: a chart review. J Neurosci Nurs. 1994;26(5):265-269. (Retrospective study; 51 patients)
  7. Browd SR, Gottfried ON, Ragel BT, et al. Failure of cerebrospinal fluid shunts: part II: overdrainage, loculation, and abdominal complications. Pediatr Neurol. 2006;34(3):171-176. (Review article)
  8. Drake JM, Kestle JR, Milner R, et al. Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurg. 1998;43(2):294-303. (Randomized controlled trial; 344 patients)
  9. Davis SE, Levy LM, McComb JG, et al. Does age or other factors influence the incidence of ventriculoperitoneal shunt infections? Pediatr Neurosurg. 1999;30:253-257. (Retrospective study; 1193 patients)
  10. McGirt MJ, Leveque JC, Wellons JC 3rd, et al. Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg. 2002;36:248-255. (Retrospective study; 353 patients)
  11. Tuli S, Drake J, Lawless J, et al. Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg. 2000;92:31-38. (Prospective study; 839 patients)
  12. Reddy GK, Bollam P, Caldito G, et al. Ventriculoperitoneal shunt complications in hydrocephalus patients with intracranial tumors: an analysis of relevant risk factors. J Neurooncol. 2011;103(2):333-342. (Retrospective study; 187 patients)
  13. Appelgren T, Zetterstrand S, Elfversson J, et al. Long-term outcome after treatment of hydrocephalus in children. Pediatr Neurosurg. 2010;46(3):221-226. (Retrospective study; 98 patients)
  14. Madikians A, Conway EE Jr. Cerebrospinal fluid shunt problems in pediatric patients. Pediatr Ann. 1997;26(1O):613-620. (Review article)
  15. * Kim TY, Stewart G, Voth M, et al. Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department. Pediatr Emerg Care. 2006;22(1):28-34. (Retrospective study; 352 patients)
  16. Green AL, Pereira EA, Kelly D, et al. The changing face of paediatric hydrocephalus: a decade’s experience. J Clin Neurosci. 2007;14(11):1049-1054. (Retrospective study; 253 patients)
  17. Goeser CD, McLeary MS, Young LW. Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics. 1998;18(3):635-651. (Review article)
  18. Mwachaka PM, Obonyo NG, Mutiso BK, et al. Ventriculoperitoneal shunt complications: a three-year retrospective study in a Kenyan national teaching and referral hospital. Pediatr Neurosurg. 2010;46(1):1-5. (Retrospective study; 117 patients)
  19. Mohammed W, Wiig U, Caird J. Spontaneous knot; a rare cause of ventriculoperitoneal shunt blockage. Br J Neurosurg. 2011;25(1):113-114. (Case report)
  20. Borcek AO, Civi S, Golen M, et al. An unusual ventriculo-peritoneal shunt complication: spontaneous knot formation. Turk Neurosurg. 2012;22(2):261-264. (Case report)
  21. Sainte-Rose C, Piatt JH, Renier D, et al. Mechanical complications in shunts. Pediatr Neurosurg. 1991;17(1):2-9. (Retrospective study; 1719 patients)
  22. Browd SR, Ragel BT, Gottfried ON, et al. Failure of cerebrospinal fluid shunts: part I: obstruction and mechanical failure. Pediatr Neurol. 2006;34(2):83-92. (Review article)
  23. Cozzens JW, Chandler JP. Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter. J Neurosurg. 1997;87(5):682-686. (Retrospective study; 71 patients)
  24. Martinez-Lage JF, Martos-Tello JM, Ros-de-San Pedro J, et al. Severe constipation: an under-appreciated cause of VP shunt malfunction: a case-based update. Childs Nerv Syst. 2008;24(4):431-435. (Case report)
  25. Muzumdar D, Ventureyra EC. Transient ventriculoperitoneal shunt malfunction after chronic constipation: case report and review of literature. Childs Nerv Syst. 2007;23(4):455-458. (Case report)
  26. Kural C, Kirik A, Pusat S, et al. Late calcification and rup-ture: a rare complication of ventriculoperitoneal shunting. Turk Neurosurg. 2012;22(6):779-782. (Case report)
  27. Yamazaki T, Shimizu S, Sagiuchi T, et al. Intractable seizures associated with proximal migration of a ventriculoperitoneal shunt. Case report. Neurol Med Chir (Tokyo). 2005;45(11):600- 603. (Case report)
  28. Coley BD, Kosnik EJ. Abdominal complications of ventriculoperitoneal shunts in children. Semin Ultrasound CT MR. 2006;27(2):152-160. (Review article)
  29. Born M, Reichling S, Schirrmeister J. Pleural effusion: beta-trace protein in diagnosing ventriculoperitoneal shunt complications. J Child Neurol. 2008;23(7):810-812. (Case report)
  30. Di Roio C, Mottolese C, Cayrel V, et al. Respiratory distress caused by migration of ventriculoperitoneal shunt catheter into the chest cavity. Intensive Care Med. 2000;26(6):818. (Case report)
  31. Nourisamie K, Vyas P, Swanson KF. Two unusual compli-cations of ventriculoperitoneal shunts in the same infant. Pediatr Radiol. 2001;31(11):814-816. (Case report)
  32. Frazier JL, Wang PP, Patel SH, et al. Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report. Neurosurgery. 2002;51(3):819-822. (Case report)
  33. Ozveren MF, Kazez A, Cetin H, et al. Migration of the abdominal catheter of a ventriculoperitoneal shunt into the scrotum--case report. Neurol Med Chir (Tokyo). 1999;39(4):313- 315. (Case report)
  34. Fisher RA, Rodziewicz G, Selman WR, et al. Liver abscess: complication of a ventriculoperitoneal shunt. Neurosurgery. 1984;14(4):480-482. (Case report)
  35. Duhaime AC. Evaluation and management of shunt infections in children with hydrocephalus. Clin Pediatr (Phila). 2006;45(8):705-713. (Review article)
  36. Turgut M, Alabaz D, Erbey F, et al. Cerebrospinal fluid shunt infections in children. Pediatr Neurosurg. 2005;41(3):131-136. (Retrospective study; 35 patients)
  37. von der Brelie C, Simon A, Groner A, et al. Evaluation of an institutional guideline for the treatment of cerebrospinal fluid shunt-associated infections. Acta Neurochir (Wien). 2012;154(9):1691-1697. (Retrospective study; 78 patients)
  38. Gassas A, Kennedy J, Green G, et al. Risk of ventriculoperitoneal shunt infections due to gastrostomy feeding tube insertion in pediatric patients with brain tumors. Pediatr Neurosurg. 2006;42(2):95-99. (Retrospective study; 51 patients)
  39. Pinto K, Jerkins GR, Noe HN. Ventriculoperitoneal shunt infection after bladder augmentation. Urology. 1999;54(2):356- 358. (Retrospective study; 21 patients)
  40. Sardelic S, Karanovic J, Rubic Z, et al. Late ventriculoperitoneal shunt infection caused by Shewanella algae. Pediatr Infect Dis J. 2010;29(5):475-477. (Case report)
  41. Viraraghavan R, Jantausch B, Campos J. Late-onset central nervous system shunt infections with Propionibacterium acnes: diagnosis and management. Clin Pediatr (Phila). 2004;43(4):393-397. (Case report)
  42. Baradkar VP, Mathur M, Sonavane A, et al. Candidal infections of ventriculoperitoneal shunts. J Pediatr Neurosci. 2009;4(2):73-75. (Retrospective study; 6 patients)
  43. Veeravagu A, Ludwig C, Camara-Quintana JQ, et al. Fungal infection of a ventriculoperitoneal shunt: histoplasmosis diagnosis and treatment. World Neurosurg. 2013;80(1-2):222. e225-e213. (Case report)
  44. Agarwal P, Malapure SM, Gupta R, et al. Round worm migration along ventriculoperitoneal shunt tract: a rare complication. J Postgrad Med. 2000;46(1):37-38. (Case report)
  45. Akbari SH, Holekamp TF, Murphy TM, et al. Surgical management of complex multiloculated hydrocephalus in infants and children. Childs Nerv Syst. 2015;31(2):243-249. (Retrospective study; 25 patients)
  46. Ersahin Y, Yurtseven T. Rare complications of shunt infection. Pediatr Neurosurg. 2004;40(2):90-92. (Review article)
  47. Kanev PM, Sheehan JM. Reflections on shunt infection. Pediatr Neurosurg. 2003;39(6):285-290. (Retrospective study; 562 procedures)
  48. da Silva PS, Suriano IC, Neto HM. Slitlike ventricle syndrome: a life-threatening presentation. Pediatr Emerg Care. 2009;25(10):674-676. (Case report)
  49. Buyukyavuz BI, Duman L, Karaaslan T, et al. Hyponatremic seizure due to huge abdominal cerebrospinal fluid pseudocsyt in a child with ventriculoperitoneal shunt: a case report. Turk Neurosurg. 2012;22(5):656-658. (Case report)
  50. Oemus K, Gerlach H, Rath FW. [A rare complication of shunt therapy. Metastasis of brain tumors by cerebrospinal fluid drainage]. Zentralbl Neurochir. 1992;53(1):25-32. (Case report)
  51. Rickert CH. Abdominal metastases of pediatric brain tumors via ventriculo-peritoneal shunts. Childs Nerv Syst. 1998;14(1- 2):10-14. (Literature review; 35 patients)
  52. * Piatt JH Jr, Garton HJ. Clinical diagnosis of ventriculoperitoneal shunt failure among children with hydrocephalus. Pediatr Emerg Care. 2008;24(4):201-210. (Retrospective study; 248 shunts)
  53. Isaacman DJ, Poirier MP, Hegenbarth M, et al. Ventriculoperitoneal shunt management. Pediatr Emerg Care. 2003;19(2):119-125. (Review article)
  54. Tsze DS, Steele DW. Neurosurgical emergencies, non-traumatic. In: Fleisher GR, Ludwid S, eds. Textbook of Pediatric Emergency Medicine. 6th ed. Philadelphia, Pennsylvania: Lippincott Williams and Wilkins; 2010:1588-1590. (Textbook)
  55. Lee TT, Uribe J, Ragheb J, et al. Unique clinical presentation of pediatric shunt malfunction. Pediatr Neurosurg. 1999;30(3):122-126. (Retrospective study; 65 patients)
  56. * Garton HJ, Kestle JR, Drake JM. Predicting shunt failure on the basis of clinical symptoms and signs in children. J Neurosurg. 2001;94:202-210. (Retrospective study; 431 encounters)
  57. Watkins L, Hayward R, Andar U, et al. The diagnosis of blocked cerebrospinal fluid shunts: a prospective study of referral to a paediatric neurosurgical unit. Childs Nerv Syst. 1994;10(2):87-90. (Prospective study; 45 patients)
  58. Barnes NP, Jones SJ, Hayward RD, et al. Ventriculoperitoneal shunt block: what are the best predictive clinical indicators? Arch Dis Child. 2002;87(3):198-201. (Prospective study; 53 patients)
  59. * Johnson DL, Conry J, O’Donnell R. Epileptic seizure as a sign of cerebrospinal fluid shunt malfunction. Pediatr Neurosurg. 1996;24(5):223-227. (Retrospective study; 817 patients)
  60. Hack CH, Enrile BG, Donat JF, et al. Seizures in relation to shunt dysfunction in children with myelomeningocele. J Pediatr. 1990;116:57-60. (Retrospective study; 346 patients)
  61. Sivaganesan A, Krishnamurthy R, Sahni D, et al. Neuroimaging of ventriculoperitoneal shunt complications in children. Pediatr Radiol. 2012;42(9):1029-1046. (Review article)
  62. * Piatt JH Jr. Physical examination of patients with cerebrospinal fluid shunts: is there useful information in pumping the shunt. Pediatrics 1992;89:470-473. (Prospective study; 200 patients)
  63. Bromby A, Czosnyka Z, Allin D, et al. Laboratory study on “intracranial hypotension” created by pumping the chamber of a hydrocephalus shunt. Cerebrospinal Fluid Res. 2007;4:2. (Laboratory study; 11 shunt models)
  64. Huang CY, Hung YC, Tai SH, et al. Cerebellar hemorrhage after multiple manual pumping tests of a ventriculoperitoneal shunt: a case report. Kaohsiung J Med Sci. 2009;25(1):29-33. (Case report)
  65. Li V, Dias MS. The results of a practice survey on the management of patients with shunted hydrocephalus. Pediatr Neurosurg. 1999;30(6):288-295. (Survey; 261 respondents)
  66. DeFlorio RM, Shah CC. Techniques that decrease or eliminate ionizing radiation for evaluation of ventricular shunts in children with hydrocephalus. Semin Ultrasound CT MR. 2014;35(4):365-373. (Review article)
  67. Zorc JJ, Krugman SD, Ogborn J, et al. Radiographic evaluation for suspected cerebrospinal fluid shunt obstruction. Pediatr Emerg Care. 2002;18(5):337-340. (Retrospective study; 233 patients)
  68. Winston KR, Lopez JA, Freeman J. CSF shunt failure with stable normal ventricular size. Pediatr Neurosurg. 2006;42(3):151-155. (Retrospective study; 12 patients)
  69. O’Brien DF, Taylor M, Park TS, et al. A critical analysis of “normal” radionucelotide shuntograms in patients subsequently requiring surgery. Childs Nerv Syst. 2003;19:337-341. (Retrospective study; 149 studies)
  70. Iskandar BJ, McLaughlin C, Mapstone TB, et al. Pitfalls in the diagnosis of ventricular shunt dysfunction: radiology reports and ventricular size. Pediatrics. 1998;101(6):1031-1036. (Retrospective study; 100 patients)
  71. Goske MJ, Applegate KE, Boylan J, et al. The Image Gently campaign: working together to change practice. AJR Am J Roentgenol. 2008;190(2):273-274. (Practice guidelines)
  72. Udayasankar UK, Braithwaite K, Arvaniti M, et al. Low-dose nonenhanced head CT protocol for follow-up evaluation of children with ventriculoperitoneal shunt: reduction of radiation and effect on image quality. AJNR Am J Neuroradiol. 2008;29(4):802-806. (Retrospective study; 92 patients)
  73. George KJ, Roy D. A low radiation computed tomography protocol for monitoring shunted hydrocephalus. Surg Neurol Int. 2012;3:103. (Pilot study; 10 patients)
  74. Pindrik J, Huisman TA, Mahesh M, et al. Analysis of limited-sequence head computed tomography for children with shunted hydrocephalus: potential to reduce diagnostic radiation exposure. J Neurosurg Pediatr. 2013;12(5):491-500. (Retrospective study; 50 patients)
  75. Alhilali LM, Dohatcu AC, Fakhran S. Evaluation of a limited three-slice head CT protocol for monitoring patients with ventriculoperitoneal shunts. AJR Am J Roentgenol. 2013;201(2):400-405. (Retrospective study; 231 studies)
  76. Desai KR, Babb JS, Amodio JB. The utility of the plain radiograph “shunt series” in the evaluation of suspected ventriculoperitoneal shunt failure in pediatric patients. Pediatr Radiol. 2007;37(5):452-456. (Retrospective study; 238 patients)
  77. * Pitetti R. Emergency department evaluation of ventricular shunt malfunction: is the shunt series really necessary? Pediatr Emerg Care. 2007;23(3):137-141. (Retrospective study; 291 patients)
  78. May CH, Aurisch R, Kornrumpf D, et al. Evaluation of shunt function in hydrocephalic patients with the radionuclide 99mTc-pertechnetate. Childs Nerv Syst. 1999;15(5):239-244. (Prospective study; 85 children)
  79. Ouellette D, Lynch T, Bruder E, et al. Additive value of nuclear medicine shuntograms to computed tomography for suspected cerebrospinal fluid shunt obstruction in the pediatric emergency department. Pediatr Emerg Care. 2009;25(12):827-830. (Retrospective study; 69 patients)
  80. Hamburg LM, Kessler DO. Rapid evaluation of ventriculo-peritoneal shunt function in a pediatric patient using emergency ultrasound. Pediatr Emerg Care. 2012;28(7):726-727. (Case report)
  81. Zaidi SJ, Yamamoto LG. Optic nerve sheath diameter measurements by CT scan in ventriculoperitoneal shunt obstruction. Hawaii J Med Public Health. 2014;73(8):251-255. (Retrospective study; 14 patients)
  82. Malayeri AA, Bavarian S, Mehdizadeh M. Sonographic evaluation of optic nerve diameter in children with raised intracranial pressure. J Ultrasound Med. 2005;24(2):143-147. (Randomized controlled trial; 156 patients)
  83. Le A, Hoehn ME, Smith ME, et al. Bedside sonographic measurement of optic nerve sheath diameter as a predictor of increased intracranial pressure in children. Ann Emerg Med. 2009;53(6):785-791. (Prospective study; 64 patients)
  84. * Iskandar BJ, Sansone JM, Medow J, et al. The use of quick-brain magnetic resonance imaging in the evaluation of shunt-treated hydrocephalus. J Neurosurg. 2004;101(2 Suppl):147-151. (Retrospective study)
  85. Boyle TP, Paldino MJ, Kimia AA, et al. Comparison of rapid cranial MRI to CT for ventricular shunt malfunction. Pediatrics. 2014;134(1):e47-e54. (Retrospective study; 298 patients)
  86. Missios S, Quebada PB, Forero JA, et al. Quick-brain magnetic resonance imaging for nonhydrocephalus indications. J Neurosurg Pediatr. 2008;2(6):438-444. (Retrospective study; 1146 images)
  87. O’Neill BR, Pruthi S, Bains H, et al. Rapid sequence magnetic resonance imaging in the assessment of children with hydro-cephalus. World Neurosurg. 2013;80(6):e307-e312. (Retrospective study; 50 patients)
  88. Wait SD, Lingo R, Boop FA, et al. Eight-second MRI scan for evaluation of shunted hydrocephalus. Childs Nerv Syst. 2012;28(8):1237-1241. (Retrospective study; 44 patients)
  89. Miller JH, Walkiewicz T, Towbin RB, et al. Improved delineation of ventricular shunt catheters using fast steady-state gradient recalled-echo sequences in a rapid brain MR imaging protocol in nonsedated pediatric patients. AJNR Am J Neuroradiol. 2010;31(3):430-435. (Retrospective study; 179 patients)
  90. Ashley WW Jr, McKinstry RC, Leonard JR, et al. Use of rapid-sequence magnetic resonance imaging for evaluation of hydrocephalus in children. J Neurosurg. 2005;103(2 Suppl):124-130. (Retrospective study; 67 scans)
  91. Kontny U, Hofling B, Gutjahr P, et al. CSF shunt infections in children. Infection. 1993;21(2):89-92. (Retrospective study; 350 procedures)
  92. Lan CC, Wong TT, Chen SJ, et al. Early diagnosis of ventriculoperitoneal shunt infections and malfunctions in children with hydrocephalus. J Microbiol Immunol Infect. 2003;36(1):47- 50. (Retrospective study; 129 patients)
  93. McClinton D, Carraccio C, Englander R. Predictors of ventriculoperitoneal shunt pathology. Pediatr Infect Dis J. 2001;20(6):593-597. (Retrospective study; 81 patients)
  94. Fulkerson DH, Boaz JC. Cerebrospinal fluid eosinophilia in children with ventricular shunts. J Neurosurg Pediatr. 2008;1(4):288-295. (Retrospective study; 93 patients)
  95. Bezerra S, Frigeri TM, Severo CM, et al. Cerebrospinal fluid eosinophilia associated with intraventricular shunts. Clin Neurol Neurosurg. 2011;113(5):345-349. (Case report)
  96. Fulkerson DH, Sivaganesan A, Hill JD, et al. Progression of cerebrospinal fluid cell count and differential over a treatment course of shunt infection. J Neurosurg Pediatr. 2011;8(6):613-619. (Retrospective study; 105 patients)
  97. Schuhmann MU, Ostrowski KR, Draper EJ, et al. The value of C-reactive protein in the management of shunt infections. J Neurosurg. 2005;103(3 Suppl):223-230. (Retrospective study; 59 patients)
  98. Asi-Bautista MC, Heidemann SM, Meert KL, et al. Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 concentrations in cerebrospinal fluid predict ventriculoperitoneal shunt infection. Crit Care Med. 1997;25(10):1713-1716. (Prospective observational study; 64 patients)
  99. Scribano PV, Pool S, Smally AJ. Comparison of ventriculoperitoneal shunt tap and lumbar puncture in a child with meningitis. Pediatr Emerg Care. 2002;18(4):E1-E3. (Case report)
  100. Leib SL, Boscacci R, Gratzl O, et al. Predictive value of cerebrospinal fluid (CSF) lactate level versus CSF/blood glucose ratio for the diagnosis of bacterial meningitis following neurosurgery. Clin Infect Dis. 1999;29(1):69-74. (Retrospective study; 73 patients)
  101. Conen A, Walti LN, Merlo A, et al. Characteristics and treatment outcome of cerebrospinal fluid shunt-associated infections in adults: a retrospective analysis over an 11-year period. Clin Infect Dis. 2008;47(1):73-82. (Retrospective study; 78 episodes)
  102. Roberts JR. Robert’s and Hedges’ Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014. (Textbook)
  103. Ladde JG. Central nervous system procedures and devices. In: Tintinalli JE, Stapczynski JS, Ma OJ, et al, eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. China: The McGraw-Hill Companies, Inc; 2011. (Textbook)
  104. Maartens NF, Aurora P, Richards PG. An unusual complication of tapping a ventriculoperitoneal shunt. Eur J Paediatr Neurol. 2000;4(3):125-129. (Case report)
  105. Vega RA, Buscher MG, Gonzalez MS, et al. Sonographic localization of a nonpalpable shunt: Ultrasound-assisted ventricular shunt tap. Surg Neurol Int. 2013;4:101. (Case report)
  106. Zeiler FA, Teitelbaum J, West M, et al. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014;21(1):163- 173. (Systematic review)
  107. Horton C, Byrd L, Lucht H, et al. Emergency care of children with high-technology neurologic disorders. Clin Pediatr Emerg Med. 2012;13(2):114-120. (Case vignettes)
  108. Vernet O, Campiche R, de Tribolet N. Long-term results after ventriculoatrial shunting in children. Childs Nerv Syst. 1993;9(5):253-255. (Prospective study; 120 patients)
  109. Keucher TR, Mealey J Jr. Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg. 1979;50(2):179-186. (Prospective study; 228 patients)
  110. Ziegler MM, Azizkhan RG, von Allmen D, et al. Operative Pediatric Surgery. China: McGraw-Hill Education; 2014. (Textbook)
  111. Sciubba DM, Stuart RM, McGirt MJ, et al. Effect of antibiotic-impregnated shunt catheters in decreasing the incidence of shunt infection in the treatment of hydrocephalus. J Neurosurg. 2005;103(2 Suppl):131-136. (Retrospective study; 211 patients)
  112. Aryan HE, Meltzer HS, Park MS, et al. Initial experience with antibiotic-impregnated silicone catheters for shunting of cerebrospinal fluid in children. Childs Nerv Syst. 2005;21(1):56-61. (Prospective study; 31 patients)
  113. Govender ST, Nathoo N, van Dellen JR. Evaluation of an antibiotic-impregnated shunt system for the treatment of hydrocephalus. J Neurosurg. 2003;99(5):831-839. (Prospective randomized controlled trial; 110 patients)
  114. Kan P, Kestle J. Lack of efficacy of antibiotic-impregnated shunt systems in preventing shunt infections in children. Childs Nerv Syst. 2007;23(7):773-777. (Retrospective study; 160 procedures)
  115. Ritz R, Roser F, Morgalla M, et al. Do antibiotic-impregnated shunts in hydrocephalus therapy reduce the risk of infection? An observational study in 258 patients. BMC Infect Dis. 2007;7:38. (Retrospective study; 258 patients)
  116. Steinbok P, Milner R, Agrawal D, et al. A multicenter multinational registry for assessing ventriculoperitoneal shunt infections for hydrocephalus. Neurosurgery. 2010;67(5):1303-46. (Prospective multicenter noncontrolled open-label registry; 440 patients)
  117. Demetriades AK, Bassi S. Antibiotic resistant infections with antibiotic-impregnated Bactiseal catheters for ventriculoperitoneal shunts. Br J Neurosurg. 2011;25(6):671-673. (Prospective study; 125 patients)
  118. Abramo TJ, Zhou C, Estrada C, et al. Innovative application of cerebral rSO2 monitoring during shunt tap in pediatric ventricular malfunctioning shunts. Pediatr Emerg Care. 2014. (Prospective case series; 94 patients)
  119. Rocque BG, Lapsiwala S, Iskandar BJ. Ventricular shunt tap as a predictor of proximal shunt malfunction in children: a prospective study. J Neurosurg Pediatr. 2008;1(6):439-443. (Prospective study; 51 patients)
  120. Miller JP, Fulop SC, Dashti SR, et al. Rethinking the indications for the ventriculoperitoneal shunt tap. J Neurosurg Pediatr. 2008;1(6):435-438. (Retrospective study; 155 patients)
  121. Petrella G, Czosnyka M, Keong N, et al. How does CSF dynamics change after shunting? Acta Neurol Scand. 2008;118(3):182-188. (Retrospective study; 25 patients)
Publication Information

Jacqueline Bober, DO, FAAP; Johnathan Rochlin, MD; Shashidhar Marneni, MD

Publication Date

February 2, 2016

CME Expiration Date

March 2, 2019

Get Permission

CME Information

Related Articles

Best Practices In The Emergency Department Management Of Children With Special Needs - Pediatric Emergency Medicine Practice - Jun 2015

Get A Sample Issue Of Emergency Medicine Practice
Enter your email to get your copy today! Plus receive updates on EB Medicine every month.
Please provide a valid email address.