1. LECTURE NOTES FROM MR CHUMAS HYDROCEPHALUS AND INSERTION OF V.P. SHUNTS

2. Hydrocephalus and Insertion of V.P. Shunts Intraventricular dilation described by Volpe in USA grades 1-111. Hydrocephalus develops 1-3 weeks after intraventricular haemorrhage. L/P dry taps – 9% infection rate. Secondary white matter damage with increasing hydrocephalus.

3. Hydrocephalus and Insertion of V.P. Shunts < 2 kg - Insertion of access device. > 2 kg - Medium pressure shunt. Post Op Shunt – sit in a car seat. Neo-nates Average Infection 2—25% GOS. LGI 5% infection rate, Fifompicin 50 days

4. Hydrocephalus and Insertion of V.P. Shunts Increase infection with prematurity. Double glove-prevention. Mortality rate doubles with shunt infection. 42% surgical instrument infection – not the patient.

5. Hydrocephalus and Insertion of V.P. Shunts Extra ventricular drainage system. Leakage. Catheter tubes antibiotic impregnated, anti-slime.

6. Hydrocephalus and Insertion of V.P. Shunts In one year – 40% V.P. Shunts fail - 10% infection Shunts – cheapest most practical.