Ventricular Catheter Tack-Down Screw

The frequent need for revision of ventriculoperitoneal shunts particularly in the pediatric population is a well-known complication of the procedure. A not infrequent etiology demanding revision is the dislodgement of the catheter, particularly, in our experience, with posterior fossa shunts. Suturing the shunt to the periosteum is a common practice amongst pediatric neurosurgeons. We describe a novel technique of fastening the reservoir directly to the skull with the aid of titanium screws providing a more secure attachment and potentially reducing the number of subsequent revisions related to proximal end displacement.