ArticleActa neurochirurgica2021
CSF shunt valve occlusion-does CSF protein and cell count matter?
Article in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- CSF drainage strategy and complication management of hydrocephalus.Frontiers in neurology · 2026Review
- The Feasibility of Early Shunting for Hydrocephalus after Subarachnoid Hemorrhage.Neurologia medico-chirurgica · 2025Article
- Nonadjustable state of programmable shunt valve: obstruction of middle cranial fossa arachnoid cyst-peritoneal shunt.Chinese neurosurgical journal · 2024Article
- Ventriculoperitoneal Shunt Failure and Cerebrospinal Fluid Protein: A Meta-Analysis and Systematic Review.Cureus · 2024Review
- Paediatric ventriculoperitoneal shunt failures: 12-year experience from a Singapore children's hospital.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
- Revision rates of flow- versus pressure-regulated ventricular shunt valves for the treatment of hydrocephalus in neonates following germinal matrix haemorrhage-a retrospective review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Article
- Neuroendoscopic lavage for the management of neonatal post-haemorrhagic hydrocephalus: a retrospective series.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShunt obstruction is a common cause of shunt failure in the treatment of hydrocephalus. Valve occlusion is traditionally believed to originate from elevated CSF protein or cellular components, although detailed evidence is scarce and contradictory. Therefore, this study aimed to examine CSF protein and cell count as risk factors for valve obstruction.
methodsWe retrospectively examined 274 patients who underwent shunt placement for hydrocephalus between 2009 and 2018 and had at least 1 year follow-up. Age, aetiology of hydrocephalus, valve type, occurrence of revision, reason for revision and CSF protein and cell count at the time of shunt insertion and revision surgery were analysed.
resultsThirty-two of 274 patients (11.7%) required revision surgery due to valve occlusion. Mean time to revision was 143 days. CSF white blood cell (WBC) count but not protein was associated with valve occlusion overall. Of all obstructed valve patients, 25% showed CSF protein level within the normal range, whereas 13.6% of the patients overall showed greatly elevated CSF protein level without evidence of valve obstruction. Persistently elevated CSF protein level at the time of shunt revision was significantly associated with valve obstruction within 90 days of initial insertion (early occlusion). Children with congenital malformations and post-haemorrhagic patients were significantly overrepresented in the occlusion group, particularly in the early occlusion group.
conclusionPathological CSF values such as WBC count and persistently elevated protein level serves as a risk factor for early valve obstruction. Late obstruction occurs independent of normal CSF values. Infants are particularly prone to early and late valve obstructions. CSF protein level at shunt insertion is not predictive of valve occlusion.
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