Paes N
Clinica de Coluna, University of Mogi das Cruzes, Tatuape, Sao Paulo, Brazil.
Childs Nerv Syst. 1996 Oct;12(10):619-25. doi: 10.1007/BF00261658.
Traditional shunts were primarily designed to manage hydrocephalus by regulating intracranial pressure. However, in some circumstances, their performance characteristics can cause them to underdrain or overdrain CSF. Overdrainage has been linked with clinical complications such as valve-dependent shunt syndrome, cranial stenosis, slit-ventricle syndrome, and subdural hematomas, and it may contribute to ventricular catheter occlusion. In addition to complications associated with hypertension and ventriculomegaly, underdrainage has been linked with residual brain edema, and subcutaneous CSF effusion has been observed at the site of cranial perforation, mainly in pediatric patients. Newer designs attempt to reduce these complications, but fall short for various reasons. The author presents a new shunt design, which utilizes variable aperture technology (patent pending) that results in the physiologic regulation of CSF flow under both positive and negative pressure conditions. This new design offers encouragement for the management of hydrocephalus and the prevention of complications due to overdrainage.