DEATH IN SHUNTED HYDROCEPHALIC CHILDREN IN THE 1990S

Using a combined search of the Children's Hospital (Birmingham, Ala,, USA) medical records and the Jefferson County Health Department death records, we reviewed all shunt-related deaths that occurred between Ja nuary 1990 and July 1996, Of these, we excluded patients who died of n onhydrocephalus-related reasons, such as bronchopulmonary dysplasia, a s well as patients who had other serious neurological illnesses such a s brain tumor and hydranencephaly, Twenty-eight patients died of shunt -related causes in the 6.5-year period, A survival analysis showed tha t 96% survived 32 months after first shunting, Of 28 patients, 23 were beyond help prior to medical evaluation, However, at least 10 of thes e patients had symptoms suggestive of shunt failure at least 24 h and as long as 2 weeks prior to their demise, We conclude that hydrocephal ic children still die of shunt failure despite the modern technology o f the 1990s, Some of these causes may be avoidable through early detec tion of symptoms, Guidelines to patients, families, and primary caregi vers should be emphasized.