What is the infection rate for ventriculosubgaleal shunts in infants with hydrocephalus?
A ventriculosubgaleal shunt (VSGS) is a temporary procedure used to drain excess cerebrospinal fluid (CSF) in infants, often those born prematurely with posthemorrhagic hydrocephalus. Because these infants may have blood or protein in their CSF that prevents permanent shunt placement, the VSGS serves as a bridge until they are stable enough for a permanent device.
What the research says
Research shows varying infection rates for ventriculosubgaleal shunts depending on the study size and specific clinical settings. A systematic review and meta-analysis of 19 studies involving 562 neonates found a pooled VSGS-related infection rate of 9% 3. In another retrospective study of 170 cases, the reported infection rate for these shunts was lower, at 5.9% 7.
A smaller study of six premature infants showed a much higher infection rate of 66.6%. However, in that specific group, only one infection occurred in the ventriculosubgaleal shunt itself; the other three infections occurred immediately after the device was converted to a permanent ventriculoperitoneal shunt 6. Additionally, some centers have reported zero infections in patients without pre-existing central nervous system (CNS) infections when using specific surgical techniques to keep the shunt pocket away from the wound 5.
What to ask your doctor
- What is the typical infection rate for ventriculosubgaleal shunts at your facility?
- How does the risk of infection change if the shunt is later converted to a permanent ventriculoperitoneal (VP) shunt?
- Are there specific surgical techniques used to reduce the risk of wound leakage or infection?
- What signs of infection should I watch for after the procedure?
This question is drawn from common patient questions about Neurology and answered using cited medical research. We do not provide individualized advice.