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A shunt has risk of infection and failure for which subsequent surgery is needed. Complications of ETV include hemorrhage (the most severe being due to basilar artery rupture), injury to neural structures (e.g. hypothalamus , pituitary gland or fornix of the brain ), and late sudden deterioration. [ 3 ]
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).
Ventriculostomy is a neurosurgical procedure that involves creating a hole (stoma) within a cerebral ventricle for drainage. It is most commonly performed on those with hydrocephalus. [1] It is done by surgically penetrating the skull, dura mater, and brain such that the ventricular system ventricle of the brain is accessed. When catheter ...
The purpose of external ventricular drainage is to divert fluid from the ventricles of the brain and allow for monitoring of intracranial pressure. An EVD must be placed in a center with full neurosurgical capabilities, because immediate neurosurgical intervention can be needed if a complication of EVD placement, such as bleeding, is encountered.
Extra attention should be placed on intracranial pressure (ICP) monitoring via an intraventricular catheter and medications to maintain ICP, blood pressure, and coagulation. [2] In more severe cases an external ventricular drain may be required to maintain ICP and evacuate the hemorrhage, and in extreme cases an open craniotomy may be required.
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.
Hakim soon discovered ventricular enlargement on imaging of the patient, however, the patient's intracranial pressure remained within normal limits. Hakim decided to remove CSF for laboratory testing and later implanted a ventriculoatrial shunt , after which the patient showed significant improvement to Hakim's surprise.
If the procedure does not successfully cure the aqueductal stenosis, a second surgery can be performed to enlarge the incision or implant a shunt. Problems that can lead to these failures and require additional surgery include the stoma becoming closed or a new membrane forming across the stoma over time. Currently there is no universal ...