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A cerebral shunt is a device permanently implanted inside the head and body to drain excess fluid away from the brain. They are commonly used to treat hydrocephalus, the swelling of the brain due to excess buildup of cerebrospinal fluid (CSF).
Scalp of a patient with an Ommaya reservoir. Dr. Ommaya handling his reservoir. An Ommaya reservoir is an intraventricular catheter system that can be used for the aspiration of cerebrospinal fluid or for the delivery of drugs (e.g. chemotherapy) into the cerebrospinal fluid.
Keen's point is one of the ventriculostomy sites used in neurosurgery, typically in pediatrics for ventriculoperitoneal shunt placement. Keen's point is located 3 cm superior and 3 cm posterior to the helix of the ear.
For example, it may be required for a patient with a lumbar–peritoneal shunt, if multiple revisions are required or overdrainage is occurring, to have it replaced with a ventriculo–peritoneal shunt (VP shunt). Shunt revisions are required due to the following complications: Over drainage; Under drainage; Infection; Blockage or obstruction
The shunt can be obstructed at the catheter or the valve itself. Cases of shunt obstruction would present with similar symptoms to untreated hydrocephalus (headaches, nausea, lethargy, etc.). [68] It can be caused by tissue, bacteria, or kinking of the catheter. Diagnosis is usually made by shunt tapping and imaging studies like CT.
When catheter drainage is permanent, it is usually referred to as a shunt. There are many catheter-based ventricular shunts that are named for where they terminate, for example, a ventriculoperitoneal shunt terminates in the peritoneal cavity, a ventriculoatrial shunt terminates within the atrium of the heart, etc.
A common procedure performed in neurosurgery is the placement of ventriculo-peritoneal shunt (VP shunt). In pediatric practice this is often implemented in cases of congenital hydrocephalus. The most common indication for this procedure in adults is normal pressure hydrocephalus (NPH). [45]
An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed.