Tommy Alfandy Nazwar, Sumarno Sumarno, Farhad Balafif, Donny Wisnu Wardhana, Ronald Aprianto Parubak, Melani Melani, Prima Putri Dyah Titisari, Christin Panjaitan, Indri Febriani
Background: Ventriculoperitoneal shunt (VPS) is an effective intervention for managing hydrocephalus; however, various complications may arise, one of which is infection due to shunt exposure. In this study, we report the incidence, risk factors, clinical presentation, and management strategies of four cases of shunt exposure in patients with hydrocephalus. Case Description: The first case involves a 1-year-10-month-old female who underwent her initial VPS placement at 7 months old due to hydrocephalus. The second case is a 3-month-old female who had a VPS placed at 20 days old for obstructive hydrocephalus and ventriculomegaly secondary to toxoplasmosis. The third case is a 15-year-old female who received a VPS due to a cerebral abscess with a prior history of tuberculous meningoencephalopathy. The fourth case is a 38-year-old male who underwent VPS placement for hydrocephalus. Two years post-intervention, the fourth patient was diagnosed with VPS exposure and subsequently underwent shunt removal. Conclusion: The identification of risk factors and clinical symptoms in patients, supported by ancillary examinations such as cerebrospinal fluid analysis, can predict the incidence of VPS infections. Bacterial VPS infections can be managed with appropriate antibiotics tailored to the specific bacterial species. However, in certain cases, surgical removal of the VPS may be considered as a measure to eradicate infectious pathogens. ©2024 Published by Scientific Scholar on behalf of Surgical Neurology International.
Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Hospital, Indonesia; Department of Clinical Microbiology, Faculty of Medicine, Brawijaya University, Saiful Anwar Hospital, East Java, Malang, Indonesia