Complications specific to lumboperitoneal shunt

For the past half-century, the lumboperitoneal shunt (LP shunt) has been the leading surgical treatment for idiopathic intracranial hypertension (IIH). More recently in Japan, this procedure has been offered in the management of Normal Pressure Hydrocephalus (NPH). In some institutions, the LP shunt comprises up to 40 % of all cerebrospinal fluid (CSF) shunting. One of the reasons that LP shunt is used when treating patients with IIH is because it is difficult to place a ventricular catheter in ventricles that are usually small, in this condition. Furthermore, the avoidance of an intracranial procedure with LP shunt spares the small risk of intracranial hemorrhage while passing a catheter through the brain parenchyma. It is to be remembered, however, that given the pathogenetic mechanism of IIH, LP shunt and optic nerve fenestration (ONF) are symptomatic treatment while reducing patients weight (diet, bariatric surgery, etc.) and/or dural sinus stenting intervene on the cause itself of IIH and therefore should be offered first.