Complications following dual placement of a Baclofen Pump and a Ventricular Shunt in People with Severe Brain Injury

Abstract Objective To assess the complications of dual placement of an intrathecal baclofen (ITB) pump and a ventriculoperitoneal shunt (VPS) in people with severe brain injury. Design Case series. Setting Referral center, ambulatory and hospitalized care. Participants Referred sample with nine subjects (5 men, 4 women) with severe brain injuries (5 traumatic brain injuries, 3 subarachnoidal haemorrhages, 1 intracerebral heamorrhage) and a mean disease duration of 6±4.5 (range 0.5-11.4) years. Methods Referred sample with nine subjects, who had both systems implanted, an ITB device and a VPS system. Interventions Not applicable. Main Outcome Measure(s) Number and type of complications occurring after implantation of the second system and subsequent interventions were assessed in the patients studied. Results In five patients the ITB delivery system was implanted after the VPS system (“ITB-group”) and in four patients, the VPS was the second implanted system (“VPS-group”). Seven complications occurred in seven patients after implantation of the second system, four in the ITB-group and three in the VPS-group: Three complications were drug-related, two complications were procedure-related and two device-related. In six patients the complication occurred within four days after implantation of the second system. Conclusions Complications are frequent in patients undergoing implantation of both an ITB delivery and a VPS system. Drug-related complications were more common. Complications occurred more often when an ITB device was implanted as a second system. The critical period is the first four days.