Muhammad Sohaib Anwer, Muhammad Ali Waqas, Atta.
Csf shunt infection; peadriatic cerebrospinal fluid shunt infection. analysis of risk factors instigating.
Professional Med J Jan ;24(1):110-5.

Hydrocephalus is the abnormal accumulation of CSF with in the ventricles and subarachnoid spaces. It is often associated with dilatation of ventricular system and increased ICP. Hydrocephalus is almost always a result of an interruption of CSF flow and rarely because of increased CSF production. The definitive treatment of hydrocephalus is surgical treatment which includes shunting and non-shunting procedures. The most common and overwhelming complications that can occur due to the CSF shunts is infection. The risk factors associated with pediatric CSF shunt infection has been analyzed in this study. Study Design: Descriptive study. Setting: Department of Neurosurgery, Nishtar Hospital Multan & Sheikh Zayed Hospital Rahim Yar Khan. Period: Three years 01-07-2013 to 01-07-2016. Method: Total 209 eligible patients who were operated for CSF shunt were keenly monitored. Several variables were observed and the responses against these variables were noted down. Post operative follow up of all these cases done for 6 months in order to notice any development of infection (clinical signs of infection & CSF examination) in CSF shunt system. Chi-square method was used applied in order to analyze the association among the variables and shunt infection development.In our population of 209 patients only twenty six patients (12.44%) suffered from shunt infection. In this study four variables were qualified as having significant association with greater risk of shunt infection. 1) Patient age. 2) Inadvertently exposure of surgical instruments to the shunt system. 3) the existence of large number of previous shunt systems. 4) manual handling of shunt system Conclusions: Four variables have been reported by this study which can be a great source of shunt infection.it is recommended that changes in clinical practice should be considered in order to avoid these. Few recommendations are as follows. 1) While handling the shunt system great care should be taken. 2) It should be taken care that the manual contact of the Surgeons with the shunt system should be minimum. 3) it is recommended that the alternatives other then the shunt insertion should be considered especially for the children. 4) Great number of previous shunt system is also a great risk factor and these patients must be handled as individuals at high risk.

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