Strengths and weaknesses of frontal versus occipital ventriculoperitoneal shunt placement: A systematic review
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REVIEW
Strengths and weaknesses of frontal versus occipital ventriculoperitoneal shunt placement: A systematic review Ehsan Keykhosravi 1 & Mohammad Reza Shahmohammadi 2 & Hamid Rezaee 3 & Mohammad Ali Abouei Mehrizi 3 & Hale Sadat Tavakkol Afshari 4 & Amin Tavallaii 1 Received: 12 May 2020 / Revised: 8 July 2020 / Accepted: 14 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Excessive accumulation of cerebrospinal fluid within the brain ventricles is called hydrocephalus, which results in increased intracranial pressure preventing brain growth or causing damage to intracranial structures due to raised intracranial pressure. One of the most common treatment options for this pathology includes the placement of a ventriculoperitoneal shunt to drain the excess fluid. The location of catheterization is traditionally considered as an important factor affecting shunt survival. In this study, we aimed to systematically review all available documents to determine the advantage and superiority of frontal or occipital shunt entry points as the two main approaches. A database search was performed in PubMed, Scopus, Embase, Web of Science, Medline, Ovid, and Google Scholar using “ventriculoperitoneal”, “shunt placement”, and “hydrocephalus” as the main key terms. Resultant articles were screened for relevancy based on predefined inclusion and exclusion criteria by two authors independently. After excluding irrelevant documents, the data of 11 related articles consisting of 3947 patients were extracted and qualitative data synthesis and pooled analysis were performed. The results of the included studies showed that although the outcomes of a higher percentage of the total review population were in favor of frontal shunt placement, there was no significant superiority for neither of these two approaches after pooled analysis of available failure rates. Findings have shown that each approach has benefits and drawbacks, and there may be other factors such as age and valve design besides the position of shunt placement that may affect the survival rate. Also, the accuracy of shunt placement as an independent factor affects the failure rate and can be improved with various image-guidance methods to minimize shunt failure. Keywords Frontal . Occipital . Ventriculoperitoneal shunt . Failure
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10143-020-01391-3) contains supplementary material, which is available to authorized users. * Amin Tavallaii [email protected] 1
Neurosurgery Department, Akbar Children Hospital, Mashhad University of Medical Sciences, P.O. Box 9177897157, Kaveh Blvd, Mashhad, Iran
2
Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Neurosurgery Department, Mashhad University of Medical Sciences, Mashhad, Iran
4
Department of Biology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
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