The effect of cerebrospinal fluid’s biochemical and cellular properties on ventriculoperitoneal shunt survival
Keywords:
Hydrocephalus, CSF biochemistry and cellularity, ventriculoperitoneal shunt survivalAbstract
Background: The burden of hydrocephalus in our region is huge. Ventriculoperitoneal (VP) shunting is the main mode of treatment of hydrocephalus. These shunts frequently malfunction, with shunt blockage being the commonest cause of shunt failure. The biochemical and cellular properties of CSF are hypothesized to contribute to shunt blockage. This study aimed to demonstrate the impact of these CSF properties on shunt survival. Materials and methods: This was a prospective cohort study. Patients were recruited into the study following VP shunt surgery for hydrocephalus. Based on their baseline CSF biochemical and cellular properties, the patients were divided into two groups; those with normal and those with abnormal CSF biochemistry and cellularity. Patients were then followed up in the neurosurgical clinics for a period of 3months during which shunt function was assessed clinically. This data was then entered to the statistical package for social sciences (IBM SPSS statistics 25.0) for data analysis. Results: A total of 82 patients met the inclusion criteria and were recruited into the study. Forty-six (56.1%) were male while 36(43.9%) of them were female. The mean age was 15.5 months (SD 23.4 months). Majority (82.9%) of the patients had congenital hydrocephalus with Dandy walker malformation being the most common congenital anomaly seen. Most patients (52.44%) had normal CSF proteins while the remainder had elevated CSF proteins. Majority of the patients had reduced levels of CSF glucose at 65.9%. The CSF cell count was normal for most of the patients at 86.6%. Elevated CSF protein concentration was associated with an increased likelihood of ventriculoperitoneal shunt failure by 8.7 times compared to the patients with normal CSF protein concentration. Reduced CSF glucose concentration was associated was also found to increase the likelihood of shunt failure in this study. There was no correlation between the CSF cell count and the likelihood of shunt failure.
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