3RD VENTRICULOSTOMY FOR SHUNT INFECTIONS IN CHILDREN

FOUR CHILDREN WITH extracranial shunts for noncommunicating hydrocepha lus suffered from recurrent or intractable shunt infections. All patie nts were resistant to or relapsed after treatment with intravenous and intrathecal antibiotics with change of the shunt apparatus. They were treated with neuroendoscopic third ventriculostomy and the removal of all implants, except for a reservoir in one patient. That child later had the reservoir removed because of persistent proteus infection. Al l patients received antibiotics for approximately 2 weeks after the op eration. There was no morbidity associated with the procedure, and all patients remain shunt independent with follow-up periods of 21 to 46 months (mean, 33 mo), although one has needed another third ventriculo stomy. We have shown that third ventriculostomy is a successful surgic al intervention for the management of shunt infections in patients wit h noncommunicating hydrocephalus.