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CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0046-1816554
Original Article

Biochemical Parameters of Cerebrospinal Fluid of Hydrocephalus Patients: Clinical Implications in Predicting Shunt Dysfunction

Authors

  • Sangeeta Sanghamitra Bhanja

    1   Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

  • Abhijit Acharya 

    2   Department of Neurosurgery, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

  • Pooja Priyadarsini

    1   Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

  • Bandana Thakur

    1   Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

  • Rama Chandra Deo 

    2   Department of Neurosurgery, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

  • Subhashree Ray

    1   Department of Biochemistry, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

  • Sumirini Puppala

    3   Department of Neurology, VMMC and Safdarjung Hospital, New Delhi, India
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Abstract

Objective

The aim of this study is to identify and establish biochemical parameters that can predict shunt blockage or malfunction in patients undergoing ventriculoperitoneal (VP) shunt surgery for hydrocephalus by analyzing cerebrospinal fluid (CSF) obtained during surgery.

Material and Methods

This retrospective study was conducted among patients with hydrocephalus who underwent VP shunt surgery in the Departments of Neurosurgery at two medical institutions during the periods 2011 to 2014 and 2021 to 2024, respectively. CSF samples were collected during shunt surgery and analyzed. Individual biochemical parameters were studied to identify potential predictive factors for shunt blockage. Each patient was followed-up for a minimum of 6 months to assess shunt malfunction or blockage. Patients with shunt malfunction due to infection or malposition were excluded.

Results

A high CSF protein value (>100 mg/dL) was found to be statistically significant in predicting the possibility of shunt blockage during follow-up in patients undergoing VP shunt surgery. The CSF protein level was also inversely proportional to the symptom-free interval following VP shunt placement.

Conclusion

The ability to predict shunt malfunction using CSF parameters prior to surgery may help a group of patients avoid unnecessary VP shunt-related complications and help surgeons in appropriate surgical planning and in explaining prognosis.

Keywords

cerebrospinal fluid - hydrocephalus - VP shunt - shunt dysfunction - hydrocephalus


Publication History

Article published online:
04 February 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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