Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurosurgery

Background: Thecoperitoneal shunting 2also named Lumboperitoneal shunting3 is an effective method to drain cerebrospinal fluid from subarachnoid space in the thecal sac of lower part of spinal canal to the abdominal cavity. It represents a less invasive option in comparison with ventriculoperitoneal (VP) shunting. However, thecoperitoneal shunting has some drawbacks. Thecoperitoneal shunting is the surgical treatment of choice of cerebrospinal fluid (CSF) shunting for idiopathic intracranial hypertension (IIH) and Normal pressure hydrocephalus (NPH) and other conditions, after failure of medical treatments and other options. Thecoperitoneal shunts have been associated with higher failure rates compared to ventriculoperitoneal shunts. However, there are some complications that jeopardize the success of the whole operation Patients and Methods: This a prospective cohort study of twenty patients suffering from IIH (85% of patients) and NPH (15% of patients) had undergone thecoperitoneal (lumboperitoneal) shunting operation in the neurosurgical departments of Al-Kasr Al-Ainy medical school and followed for 2 years postoperatively to notice the postsurgical complications of this operation. Results: Eleven cases (55%) out of twenty developed at least one complication, most of them due to obstructed catheter (63%), beside other complications like migration (36%), CSF leak (27%) and infection (18%). Conclusions: Most of postsurgical complications were due to mechanical problems like obstruction and migration especially in the distal end. Obesity and increased age are major risk factors for developing complications

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