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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).
The Wade-Dahl-Till (WDT) valve is a cerebral shunt developed in 1962 by hydraulic engineer Stanley Wade, author Roald Dahl, and neurosurgeon Kenneth Till. [1] [2] In 1960, Dahl's son Theo developed hydrocephalus after being struck by a taxicab. A standard Holter shunt was installed to drain excess fluid from his brain.
For suspected cases of NPH, CSF shunting is the first-line treatment. The most common type used to treat NPH is ventriculoperitoneal (VP) shunts, which drain CSF fluid to the peritoneal cavity. Adjustable valves allow fine-tuning of CSF drainage. NPH symptoms reportedly improve in 70–90% of patients with CSF shunt.
Nowadays, following his father steps, Carlos, Hakim's eldest son, has continued his father's research in neurosurgery and engineering. Carlos, with the collaboration of his father, has recently developed a programmable and adjustable (through the skin) valve which may prevent ventricular collapse when the pressure of the CSF is too low.
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.
Resistance to traditional analgesic pharmacological therapy may also be a sign of shunt overdrainage or failure. [49] Following placement of a ventriculoperitoneal shunt there have been cases of a decrease in post-surgery hearing. It is presumed that the cochlea aqueduct is responsible for the decrease in hearing thresholds.
Unlike the ventriculoperitoneal shunt, however, a lumbar-peritoneal shunt is usually inserted in between two of the vertebrae in the lumbar and punctures the cerebrospinal fluid sack or lumbar subarachnoid space, it then runs beneath the skin to the peritoneal cavity, where it is eventually drained away by the normal bodily fluid drainage ...
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.