Shunts and shunt complications

Hydrocephalus is a common entity in neurosurgical practice affecting both adult and pediatric populations. VP shunts are the standard of care for most patients suffering from hydrocephalus, even with the introduction of more advanced therapeutic options such as endoscopic ventriculostomy. Shunt insertion procedures are the bread and butter of neurosurgery practice; however, they pose a huge financial, social, psychological burden due to the associated high rate of complications. Nevertheless, shunt complications are inevitable during a patient’s lifetime. Such complications are associated with high mortality and morbidity, so precise knowledge of shunt types, shunt hard hardware, common, and uncommon complications are vital to decrease the mortality and morbidity associated with such therapeutic entity. The main objective of this chapter is to give an overview of different shunt systems and help neurosurgeons identify early complications in a timely manner to reduce morbidity and mortality. This chapter will discuss in details shunt systems including its components, materials, and different types. Moreover, shunt types will also be discussed emphasizing indications, positioning, and contraindications. Shunt complications, early and late, are also discussed, focusing mainly on clinical features and diagnostic methods.