ArticleSurgical neurology international2026
Distal ventriculoperitoneal shunt catheter migration in pediatric hydrocephalus: A retrospective institutional case series and systematic review of published pediatric cases.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background: Distal ventriculoperitoneal shunt (VPS) catheter migration is uncommon but may lead to shunt failure and infection. This study aimed to characterize pediatric distal VPS migration at Dr. Saiful Anwar General Hospital, Indonesia, and to synthesize evidence. Methods: We conducted a retrospective case series of children aged 0-18 years with hydrocephalus who underwent VPS placement between January 2020 and December 2024. Distal catheter migration was identified clinically and/or radiologically. A preferred reporting items for systematic reviews and meta-analyses-guided systematic review of English-language case reports, and case series published from 2014 to June 2025 was also performed using PubMed, ScienceDirect, SpringerLink, and the Cochrane Library. Data on migration site, recurrent hydrocephalus, infection, and management were extracted. Study quality was assessed using the Joanna Briggs Institute tools. Results: Seven migrations were identified among 453 VPS procedures, yielding an incidence of 1.55%; infection occurred in one patient. The review included 59 publications comprising 66 cases. The mean patient age was 44.7 ± 53.8 months, and mean time to migration was 31.2 ± 45.8 months. Infection was not associated with a broad migration-site category. However, contamination-related migration involving visceral or hollow-organ perforation/extrusion showed higher infection rates than relatively sterile-site migration. Hydrocephalus recurrence differed significantly by migration site. Conclusion: Distal VPS migration is rare but frequently requires operative management. A broad migration-site category was associated with hydrocephalus recurrence but not infection; however, contamination-related visceral or hollow-organ involvement was associated with higher infection frequency. These findings should be interpreted cautiously because of the small institutional sample and the case-report-derived evidence base.
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