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The average(range)number of revisions of shunts per person was 3.6(0-28). Although 37 patients underwent an emergency operation for revision in their first year of life,there was a continuing low incidence,increasing in the early teenage years,which persisted into the third decade.Intervals between emergency revisions varied:202/320 occurred within one year of the last shunt operation,56 occurred after five years,24 after 10 years,and 15 after 15 or more years.Fifteen patients had chronic intermittent headaches,of whom four died and three suffered severe morbidity.Thirteen died;three had raised intracranial pressure,and four died suddenly;these deaths were presumed to be related to their shunts.Up to the age of 16 there was 100%hospital follow up,but after that only 40%of young adults underwent review,including review of their shunt function.Shunts to control hydrocephalus may fail after many years without symptoms.This is difficult to diagnose and if missed may lead to chronic morbidity and death.As hospital follow up of this group is falling,both general practitioners and hospital doctors must be aware that a shunt may malfunction after prolonger quiescent periods. |
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headache
headache,chronic
hydrocephalus
intracranial pressure,increased
mortality
personality change
shunt procedure,ventricular
shunt procedure,ventricular-complications of
spina bifida
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