Shortening of ventricular shunt catheter associated with cranial growth: effect of the frontal and parieto-occipital access route on long-term shunt patency

The authors present the difference of shortening the ventricular shunt catheter associated with growth of the cranium between the frontal and parieto-occipital access, a key for long patency of the shunt implanted in children. Our retrospective study included 28 children. In group A (n = 9), the catheter was inserted through a frontal burr hole and in group B (n = 19), through a parieto-occipital burr hole. To compare changes that occurred in the interval between the time of insertion and follow-up in the length of the ventricular catheter in the cranium and to assess displacement of the burr used for catheter entry. The results show that ventricular catheter shortening and burr-hole displacement were more pronounced in group A. This study documents that insertion of the ventricular catheter via the frontal route in children resulted in a higher incidence of shortening due to greater displacement of the burr hole adjacent to the coronal suture. Therefore, we recommend that the parieto-occipital route be used to maintain long-term shunt function.