While most of the literature suggests a higher VP shunt failure rate in children younger than one year of age, a very small amount of literature argues differently. For example, one 11-year retrospective study looked at 137 children who received VP shunts for hydrocephalus.⁴ Ages ranged from 1.5 months to 8.5 years with an average age of 20.7 months. The incidence of VP shunt complication requiring revision was only 27 percent (n=37), and only 24 percent (n=9) of the total revisions presented within the first six months. Eighteen of the VP shunt revisions (49 percent) occurred more than 24 months after the initial placement. The patient population receiving the initial shunt, though, appeared to be older than most other studies and may have contributed to these variable findings.

Overall, the literature suggests that most VP shunt malfunctions requiring revision probably occur within the first year of placement.

Summary

While VP shunt malfunctions can occur at any time in children, the majority of VP shunt malfunctions requiring revision appear to occur within the first year after placement.

Dr. Jones is associate professor at the department of emergency medicine and pediatrics and the program director of pediatric emergency medicine fellowship at the University of Kentucky in Lexington, Ky.

Dr. Cantor is the emeritus medical director for the Central New York Poison Control Center and professor of emergency medicine and pediatrics in Syracuse, N.Y.

References

1. Ghritlaharey RK, Budhwani KS, Shrivastava DK, Srivastava J. Ventriculoperitoneal shunt complications needing shunt revision in children: a review of 5 years of experience with 48 revisions. Afr J Paediatr Surg. 2012;9(1):32-39.
2. Ghritlaharey RK. Management of ventriculoperitoneal shunt complications in children: A review of 34 cases. Afr J Paediatr Surg. 2023;20(2):109-115.
3. Riva-Cambrin J, Kestle JR, Holubkov R, et al. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. J Neurosurg Pediatr. 2016;17(4):382-390.
4. Pan P. Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus. J Pediatr Neurosci. 2018;13(2):176-181.