Sait KAYHAN, Adem DOĞAN, Şahin KIRMIZIGÖZ, Mehmet Can EZGÜ, Mehmet Ozan DURMAZ, Demet Evleksiz KARIMZADA, Ecma YILMAZ, Cafer AK, Sezen Yılmaz SARIALTIN, Yusuf İZCİ
Gulhane Medical Journal - 2026;68(2):138-146
Aims: Hydrocephalus in children can be treated using various surgical techniques, each associated with distinct risks of infection and revision. This study aimed to evaluate and compare these risks associated with different surgical approaches in pediatric patients. Methods: This retrospective study included pediatric patients aged 0-60 months who underwent surgical treatment of hydrocephalus between January 2010 and October 2020 at a tertiary neurosurgical centre. Demographic, clinical, and laboratory data were analysed, including cerebrospinal fluid (CSF) protein levels and microbiological culture results. The primary endpoint was the occurrence of postoperative infection, which was compared across surgical techniques and age groups. Results: Eighty-seven children (mean age 11+/-3 months; 56.3% male) were included. Five surgical techniques were performed: ventriculoperitoneal shunting (VPS), external ventricular drainage, Ommaya reservoir insertion, endoscopic third ventriculostomy (ETV), and combined ETV+VPS. Infection occurred in 12 patients (13.8%), with significantly higher rates in neonates than in older children (25.9% vs. 8.3%, p=0.042). Among procedures, infections were more frequent in patients who underwent Ommaya reservoir implantation than in patients treated with other methods (28% vs. 8%, p=0.034). CSF protein levels showed no significant correlation with age or sex. Conclusions: Neonatal age and Ommaya reservoir use were associated with an increased risk of infection in pediatric hydrocephalus. Careful patient selection and early conversion to definitive shunt procedures may help reduce infection-related complications.
