gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Relevance of postoperative imaging in VP-shunting procedures

Meeting Abstract

  • Petra Schödel - Department of Neurosurgery, Regensburg, Deutschland
  • Kathrin Kiene - Department of Neurosurgery, Regensburg, Deutschland
  • Elisabeth Bründl - Department of Neurosurgery, Regensburg, Deutschland
  • Florian Zeman - Zentrum für klinische Studien, Regensburg, Deutschland
  • Alexander Brawanski - Department of Neurosurgery, Regensburg, Deutschland
  • Karl-Michael Schebesch - Department of Neurosurgery, Regensburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.14.01

doi: 10.3205/17dgnc253, urn:nbn:de:0183-17dgnc2530

Published: June 9, 2017

© 2017 Schödel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: This study was designed to evaluate the relevance of immediate postoperative imaging in ventriculoperitoneal-shunting (VP-shunting) procedures.

Methods: 461 consecutive patients (male 243, female 218; mean age 51.9 years) with VP-shunting procedures who presented during the ten years interval between 2002 and 2012 were included in the study. We reviewed the charts for type of hydrocephalus, type of shunting and of the utilized hardware, postoperative imaging consisting of cranial CT- or MR-scans and x-rays of the entire shunt system, re-operations and valve-adjustments in short-term course, ventricular and peritoneal catheter-malpositioning as well as intracranial bleeding complications.

Results: There were clinically relevant findings in postoperative CT- or MR-scans in 39 patients (8.5%), leading to re-operations in 18 (3.9%) patients and valve-adjustments in 23 (5.0%) patients. Therapeutic relevant findings on x-rays were seen in 11 (2.4%) patients resulting in re-operations in all cases, mostly requiring re-positioning of the peritoneal catheter (6 patients, 1.3%). There was no intracranial bleeding leading to immediate surgical revision. Valve-adjustments due to imaging (CT, MR or x-rays) or clinical findings (high or low intracranial pressure) had been made in a total of 36 patients (7.8%) at discharge.

Conclusion: This study confirms that postoperative cranial CT- or MR-scans are clinically relevant because of therapy-deciding findings in 8.5% of all patients. As radiographical relevant findings mostly occur in x-rays of the peritoneal catheter (1.3%), it should be considered to skip all postoperative x-rays of the VP-shunt except the abdominal x-rays in order to minimize the radiation exposure.