Journal of neurosurgery. Pediatrics · 2026
Ventriculosubgaleal shunt placement as a temporary option for the management of postinfectious hydrocephalus: a single-arm meta-analysis.
СтатьяМетаанализНазвание и аннотация: Перевод в очереди
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Faquini Igor V, Alves Gercivan Dos Santos, Cezar Junior Auricelio B, Lemos Luiz Euripides A S, Lages Armando L, da Silva Junior Adelson B, Barbosa de Moura José Fernando, Gomes Emian F P, de Lima João E Silva, Monteiro Matheus Q, Ferreira João G, de Lima Cabral Wendell F
Аннотация
OBJECTIVE: Postinfectious hydrocephalus (PIH) is a severe complication following CNS infections and often requires urgent CSF diversion. However, definitive shunt placement procedures are often unfeasible in this setting due to active infection or residual inflammatory debris. In such scenarios, ventriculosubgaleal shunt (VSGS) insertion has emerged as a widely used temporary strategy.
METHODS: The authors conducted a systematic search of publications in the PubMed, Embase, and Cochrane Library databases, covering studies published up to June 2025. Risk of bias was assessed using Cochrane's Risk of Bias in Non-randomized Studies of Interventions tool. Data analysis was performed using RStudio (version 2025.05.0).
RESULTS: Seven studies involving 225 patients were included in the analysis. Meta-analysis of the reviewed studies revealed that the conversion rate to ventriculoperitoneal shunt placement was 88.6% (95% CI 68.78%-96.48%, I2 = 76.1%). Among the studies, 3 reported the time to conversion, with a 95% CI of 30.13-56.58 days (I2 = 89.4%). Regarding complications, the revision rate was 25.66% (95% CI 19.37%-33.15%, I2 = 0%), the obstruction rate was 13.7% (95% CI 6.34%-27.12%, I2 = 48.5%), the infection rate was 5% (95% CI 1.03%-21.09%, I2 = 68.7%), and the migration rate was 3.87% (95% CI 1.46%-9.87%, I2 = 0%). The overall mortality rate was 13.9% (95% CI 5.21%-32.16%, I2 = 68.2%).
CONCLUSIONS: VSGS placement represents an acceptable temporary therapy for PIH. However, more studies with larger cohorts and direct comparisons with other therapeutic strategies are necessary to establish the efficacy and long-term outcomes of VSGS use.
METHODS: The authors conducted a systematic search of publications in the PubMed, Embase, and Cochrane Library databases, covering studies published up to June 2025. Risk of bias was assessed using Cochrane's Risk of Bias in Non-randomized Studies of Interventions tool. Data analysis was performed using RStudio (version 2025.05.0).
RESULTS: Seven studies involving 225 patients were included in the analysis. Meta-analysis of the reviewed studies revealed that the conversion rate to ventriculoperitoneal shunt placement was 88.6% (95% CI 68.78%-96.48%, I2 = 76.1%). Among the studies, 3 reported the time to conversion, with a 95% CI of 30.13-56.58 days (I2 = 89.4%). Regarding complications, the revision rate was 25.66% (95% CI 19.37%-33.15%, I2 = 0%), the obstruction rate was 13.7% (95% CI 6.34%-27.12%, I2 = 48.5%), the infection rate was 5% (95% CI 1.03%-21.09%, I2 = 68.7%), and the migration rate was 3.87% (95% CI 1.46%-9.87%, I2 = 0%). The overall mortality rate was 13.9% (95% CI 5.21%-32.16%, I2 = 68.2%).
CONCLUSIONS: VSGS placement represents an acceptable temporary therapy for PIH. However, more studies with larger cohorts and direct comparisons with other therapeutic strategies are necessary to establish the efficacy and long-term outcomes of VSGS use.