The Impact of Hydrocephalus Shunt Devices on Quality of Life

Abstract

Background: Despite advances in hydrocephalus shunt technology and improvement in hydrocephalus management, many patients have chronic disability and require multiple surgeries throughout their lifetime. There is limited data from patients' perspective regarding the impact of shunt devices on quality-of-life. Methods: A cross-sectional survey was developed to evaluate the impact of shunt devices on patient quality-of-life. The survey was distributed via social media platforms of the Hydrocephalus Association, and patients self-selected to anonymously complete the online questionnaire. A literature review was performed to contextualize the findings from the survey. Results: A total of 562 survey responses were obtained from a network encompassing 35,000 members. The mean age was 30 years old (0.5-87), and 65% identified as female. Eighty one percent underwent at least 1 shunt revision surgery, with a reported average of 10 shunt revision surgeries per patient (1-200 surgeries).Occlusion, shunt migration and infection were the leading causes for revision at 60%, 47%, and 35%, respectively. In addition, 72% of patients reported pain and discomfort from the device, and 68% expressed avoidance of certain activities due to ''fear of bumping shunt.'' Despite numerous articles discussing shunt technology, a review of the literature indicated a paucity of studies specifically evaluating the burden of shunt devices from a patient/caregiver perspective. Conclusions:The findings from this study suggest long-term physical and psychosocial burden associated with shunt devices. Importantly, this study highlights the need for concerted efforts to develop validated tools to study patient reported outcomes as it relates to neurocranial implanted devices.

Mechanisms of neuroinflammation in hydrocephalus after intraventricular hemorrhage: a review

“…Fluids and Barriers of the CNS infection which can lead to potentially lethal ventriculitis or meningitis [13,14]. This is in addition to the long-term psychosocial burden associated with shunt devices affecting quality of life in both children and adults [15]. Though prior studies have tried ventricular drainage, irrigation and fibrinolytic therapy in pediatric patients with GMH-IVH, they were unsuccessful in preventing the need for a shunt [16].…”

A Novel Non-Invasive Intervention for Removing Occlusions From Shunts Using an Abrading Magnetic Microswarm

“…Hydrocephalus is a medical condition in which an abnormal amount of cerebrospinal fluid (CSF) accumulates in the ventricles (or cavities) of the brain. A shunt is placed vertically from the patient's brain to another area of the patient's body to drain the excess CSF [3].…”

“…Shunt malfunction is a serious challenge, especially in cases where repeated surgeries are necessary throughout the patient's life. There is a high risk of recurrent surgery for elderly patients sixty-five years of age and older [3] and children [4]. In addition, as the recurrent surgeries or the non-invasive approach presented here need monitoring (MRI/CT/X-ray), the healthcare costs will be increased [5].…”

The role of surgery in relieving calcified shunt site-related pain in patients with functioning VP shunt

“…Ventriculoperitoneal (VP) shunt insertion is one of the commonest procedures performed in paediatric neurosurgery. Complications following shunt insertion are common [1] and often require multiple revisions of the system with a negative impact on patients' quality of life [2].…”