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17 - Hydrocephalus shunts

Principles, hardware, shunt testing

from Section 4 - Treatment and outcomes

Published online by Cambridge University Press:  05 February 2014

By
Zofia Czosnyka ,
Krzysztof Cieslicki ,
Hugh K. Richards ,
John D. Pickard  and
Marek Czosnyka
Edited by
Daniele Rigamonti
Daniele Rigamonti
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

Hydrocephalus is caused by different etiological factors, but the common final pathway creates a vicious circle of altered cerebrospinal fluid (CSF) circulation, cerebral blood flow, and metabolism that affects brain homeostasis. In communicating hydrocephalus, draining of CSF appears to be the simplest way of interrupting this circle by improving the CSF circulation. The mathematical model of CSF pressure volume compensation provides a theoretical basis for the differential diagnosis of hydrocephalus. Eighteen nonprogrammable and eight programmable valves reveal the common hydrodynamic properties of contemporary shunts. Any repetitive variations of proximal pressure have a tendency to decrease the nominal operating pressure of shunts with unidirectional valves. Shunt operating pressure is the value of intracranial pressure (ICP) that should be fixed when the opened shunt is draining CSF with the rate equal to that of its production. It is slightly higher than shunt opening pressure.

Keywords

pressure hydrocephalusgait dysfunctionnormal pressure hydrocephalusurinary dysfunctiondifferential diagnosiscognitive deficitdif erential diagnosiscerebrospinal fluid
Type
Chapter
Information
Adult Hydrocephalus , pp. 190 - 206
Publisher: Cambridge University Press
Print publication year: 2014

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