The value of multiple shunt systems in the treatment of nontumoral infantile hydrocephalus.

A multiple shunt system has been employed in nine children with hydrocephalus combined with absent or insufficient communication with intracranial-filled spaces. The common feature of the different lesions to such a shunt system is a pressure difference, which can be adjusted by this procedure. There arise four general indications: the uniform drainage of CSF spaces which do not communicate with each other; the uniform drainage of CSF and other separate liquid filled intracranial spaces; to obtain gradual and steady diminution of enormously dilated CSF or other fluid-filled spaces; the use of both sides for shunting in cases with recurrent failures of a unilateral drainage. The postoperative efficacy of a multiple shunt can be proved by demonstrating evenly decreasing CSF and other fluid-filled cavities, and by equilibrium between their different pressures. Evaluation of possible shunt failure in a multiple system requires CT and ICP recordings.