Shortened platelet lifespan in patients with hydrocephalus and ventriculojugular shunts: Results of preliminary attempts at correction

Evidence of disseminated intravascular coagulation was sought in 30 asymptomatic children with ventriculojugular shunts. In only three patients were elevated titers of fibrin split products present. In contrast to the paucity of abnormalities uncovered by routine coagulation studies the performance of platelet survival studies revealed that 5 of the 12 patients so studied had significant reductions in the lifespans of the transfused platelets. In two of these patients treatment with aspirin and dipyridamole was instituted. Following two weeks of therapy the platelet survival times returned to normal and near normal. It is proposed that the presence of Silastic catheters in the circulation results in platelet aggregation at the catheter tip and serves as a forerunner of thrombus formation. Drugs which inhibit platelet aggregation such as aspirin and dipyridamole may prove to be useful agents for the prevention of obstructive and thromboembolic complications of ventriculojugular shunts.