Borowitz B, Ashkenazi E, Muallem N, Constantini S
Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel.
Childs Nerv Syst. 1989 Oct;5(5):330-1. doi: 10.1007/BF00274524.
Antisiphon device (ASD) tear was found in nine patients who underwent ventriculoperitoneal (VP) shunt revision of a Pudenz three-piece system. In six cases this was the only finding, in three, there was an associated distal malfunction. Repair of ASD tear constituted 27% of our shunt revision procedures. The locus minoris resistentia of the Pudenz ASD is the attachment of the diaphragm to the cylinder. ASD tear should be suspected whenever a noninflammatory fluid collection of a CSF leak are found at the proximal extracranial section of this system.