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Ventriculojugular shunt against the direction of blood flow

III. Operative technique and results

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Abstract

One hundred hydrocephalic patients were treated over a 5-year period by shunting the cerebrospinal fluid (CSF) to the internal jugular vein (IJV) against the direction of blood flow. The patients were divided into two groups according to rigidity of their craniums. The pressures recorded during the operations confirmed the results of the experiments in Part II of this investigation. Fifteen patients had their shunting catheters removed or died due to infection (14 patients) or hemorrhage inside a brain tumor (1 patient). The shunts of 12 patients were revised due to technical faults that were corrected in 9 cases. There were no failures or complications related to the dynamics of the shunt. In the 82 patients who benefitted from the shunt, the clinical improvement was dramatic. Regression of the ventriculomegaly was inversely proportional to the degree of preoperative ventricular dilatation. In 5 infants the size of the enlarged head was reduced during surgery. Valveless shunting catheters were used in the first 4 patients, and specially designed valved catheters were used in 96 patients. The follow-up period was up to 5 years.

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References

  1. Anderson FM (1952) Subdural haematoma, a complication of operation for hydrocephalus. Pediatrics 10:11–18

    CAS  PubMed  Google Scholar 

  2. Anderson H (1966) Craniostenosis as a complication after operation for hydrocephalus. Acta Paediatr Scand 55:192–196

    Article  Google Scholar 

  3. Becker CP, Nulsen EE (1968) Control of hydrocephalus by valve regulated venous shunt: avoidance of complications in prolonged shunt maintenance. J Neurosurg 28:215–226

    Article  CAS  Google Scholar 

  4. Cushing H (1926) Studies in intracranial physiology and surgery. Oxford University Press, London

    Google Scholar 

  5. Davidoff MM, Feiring EH (1953) Subdural haematoma occurring in surgically treated hydrocephalic children with a note on a method of handling persistent accumulations. J Neurosurg 10:557–563

    Article  CAS  Google Scholar 

  6. Davson H (1967) The cerebrospinal fluid pressure. In: Dason H (ed) Physiology of the cerebrospinal fluid. Churchill Livingstone, London, pp 337–382

    Google Scholar 

  7. El-Shafei IL (1975) Ventriculo-venous shunt to the proximal segment of an occluded neck vein. Surg Neurol 3:237–244

    CAS  PubMed  Google Scholar 

  8. El-Shafei IL (1985) Ventriculovenous shunt against the direction of blood-flow: a new approach for shunting the cerebrospinal fluid to the venous circulation. Child's Nerv Syst 1:200–207

    Article  CAS  Google Scholar 

  9. Emery JL, Hilton HB (1961) Lung and heart complications of the treatment of hydrocephalus by ventriculo-auriculostomy. Surgery 50:309–314

    CAS  PubMed  Google Scholar 

  10. Erdohazi M, Eckstein HB, Crome L (1966) Pulmonary embolization as a complication of ventriculo-atrial shunt inserted for hydrocephalus. Dev Med Child Neurol [Suppl] 11:36–44

    Google Scholar 

  11. Foltz EL (1966) The first seven years of a hydrocephalus project. In: Schulman K (ed) Workshop in hydrocephalus. University of Pennsylvania Press, Philadelphia

    Google Scholar 

  12. Foltz EL, Shurtleff DB (1966) Conversion of communicating hydrocephalus to stenosis or occlusion of the aqueduct during ventricular shunt. J Neurosurg 24:520–529

    Article  CAS  Google Scholar 

  13. Forrest DM, Cooper W (1968) Complications of ventriculoatrial shunts: a review of 455 cases. J Neurosurg 29:508–512

    Article  Google Scholar 

  14. Forrest JL, Hilton HB (1961) Lung and heart complications of the treatment of hydrocephalus by ventriculo auriculostomy. Surgery 50:309–314

    Google Scholar 

  15. Fox JL, McCullough DC, Green RC (1973) Alterations in CSF pressures following insertion of CSF shunts for hydrocephalus. 5th International Congress of Neurological Surgery, Tokyo 1973. (Excerpta Medica, no 293) Excerpta Medica, Amsterdam, p 43

    Google Scholar 

  16. Fox JL, McCullough DC, Green RC (1973) Effect of CSF shunts on intracranial pressure and CSF dynamics. II. A new technique of pressure measurement, results and concepts. J Neurol Neurosurg Psychiatry 36:302–312

    Article  CAS  Google Scholar 

  17. Fox JL, Portnoy HD, Shulte RR (1973) Cerebrospinal fluid shunts: an experimental evaluation of flow rates and pressure values in the antisiphon valve. J Surg Neurol 1:299–302

    CAS  Google Scholar 

  18. Griffiths DJ (1971) Steady flow through veins and collapsible tubes. Med Biol Eng 9:597–601

    Article  CAS  Google Scholar 

  19. Griffiths DJ (1972) Negative resistance effects in flow through collapsible tubes. Med Biol Eng 13:785–792

    Article  Google Scholar 

  20. Haynes IS (1913) Congenital internal hydrocephalus. Its treatment by drainage of the cysterna magna into the cranial sinuses. Ann Surg 57:449–484

    Article  CAS  Google Scholar 

  21. Haynes IS (1914) Further experience in the treatment of hydrocephalus by cisterna sinus drainage (author's operation). NY State J Med 16:174–181

    Google Scholar 

  22. Haynes IS (1915) Hydrocephalus — later experiences in its treatment by cisterna drainage. NY Med Rev 87:751–752

    Google Scholar 

  23. Holt JP (1941) The collapse factor in the measurement of venous pressure. Am J Physiol 134:292–297

    Article  Google Scholar 

  24. Holt JP (1969) Flow through collapsible tubes and through in situ veins. IEEE Trans Biomed Eng 16:274–277

    Article  CAS  Google Scholar 

  25. Horwitz NH, Rizzoli HV (1967) Postoperative complications in neurosurgical practice: recognition, prevention and management. Williams & Wilkins, Baltimore

    Google Scholar 

  26. Ilingsworth RD (1970) Subdural hematoma after treatment of chronic hydrocephalus by ventriculo caval shunts. J Neurosurg Psychiatry 33:95–99

    Article  Google Scholar 

  27. Illingsworth RD, Logue V, Symon L (1971) The ventriculo caval shunt in the treatment of adult hydrocephalus: results and complications in 101 patients. J Neurosurg 35:681–695

    Article  Google Scholar 

  28. Ingraham FD, Matson DD, Alexander E Jr, Woods RP (1948) Studies in the treatment of experimental hydrocephalus. J Neuropathol Exp Neurol 7:123–143

    Article  CAS  Google Scholar 

  29. Kanaval AB (1910) Discussion. Surg Gynecol Obstet 10:327

    Google Scholar 

  30. Kloss JL (1968) Craniosynostosis secondary to ventriculo atrial shunt. Am J Dis Child 116:315–317

    CAS  PubMed  Google Scholar 

  31. McCabe WL, Smith JC (1967) Fluid flow phenomenon, chap 3, 2nd edn.. In. Unit operations of chemical engineering. McGraw Hill, New York, pp 47–67

    Google Scholar 

  32. McCullough DC, Fox JL (1974) Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to the production of subdural hematoma. J Neurosurg 40:372–375

    Article  CAS  Google Scholar 

  33. McCullough DC, Fox JL, Curl FD (1972) Effect of CSF shunts on intracranial pressure and CSF dynamics. In: Harbert JC (ed) Cisternography and hydrocephalus. Thomas, Springfield, Ill, pp 335–342

    Google Scholar 

  34. McLure RD (1909) Hydrocephalus treated by drainage into a vein in the neck. Johns Hopkins Hosp Bull 20:110–113

    Google Scholar 

  35. Matson DD (1969) Neurosurgery of infancy and childhood, 2nd edn. Thomas, Springfield, Ill

    Google Scholar 

  36. Milhorat TH (1972) Hydrocephalus and cerebrospinal fluid. Williams & Wilkins, Baltimore

    Google Scholar 

  37. Noonan JA, Ehmke DA (1963) Complications of ventriculovenous shunts for control of hydrocephalus. Report of three cases with thrombo emboli to the lungs. N Engl J Med 265:70–74

    Article  Google Scholar 

  38. Noordergraaf AL (1978) Circulatory system dynamics, chap 5. Academic Press, New York London

    Google Scholar 

  39. Nugent GR, Lucas R, Judy M (1966) Thrombo-embolic complications of ventriculo-atrial shunts: angio cardiographic and pathologic correlations. J Neurosurg 24:34–42

    Article  CAS  Google Scholar 

  40. Nulsen FE, Becker DP (1967) Control of hydrocephalus by valve-regulated shunt. J Neurosurg 26:362–374

    Article  CAS  Google Scholar 

  41. Overton MC III, Snodgrass SR (1965) Ventriculo-venous shunts for infantile hydrocephalus. A review of five years experience with this method. J Neurosurg 23:517–521

    Article  Google Scholar 

  42. Portnoy HD, Croissant PD (1973) New devices for hydrocephalus shunts. 5th International Congress of Neurological Surgery, Tokyo 1973. (Excerpta Medica, no 293) Excerpta Medica, Amsterdam, p 44

    Google Scholar 

  43. Portnoy HD, Schulte RR, Fox JL (1973) Antisiphon and reversible occlusion valves for shunting in hydrocephalus and preventing post shunt subdural hematomas. J Neurosurg 38:729–738

    Article  CAS  Google Scholar 

  44. Pudenz RH, Russell FE, Hurd AH, Cheldon CH (1957) Ventriculo-auriculostomy. A technique for shunting cerebrospinal fluid into the right auricle. Preliminary report. J Neurosurg 14:171–179

    Article  CAS  Google Scholar 

  45. Samuelson S, Long DM, Chou SN (1972) Subdural hematoma as a complication of shunting procedures for normal pressure hydrocephalus. J Neurosurg 37:548–551

    Article  CAS  Google Scholar 

  46. Sperling DR, Ratrick JR, Anderson FM, Fyler DC (1964) Corpulmonale secondary to ventriculo-auriculostomy. Am J Dis Child 107:308–315

    CAS  PubMed  Google Scholar 

  47. Streeter VL (1962) Viscous effects — fluid resistance. In: Fluid mechanics, 3rd edn. McGraw Hill, New York, pp 293–206

    Google Scholar 

  48. Strenger L (1963) Complications of ventriculo-venous shunts. J Neurosurg 20:219–224

    Article  CAS  Google Scholar 

  49. Van Buskirk C (1959) Neuromedical conditions resembling surgical problems. In: Jackson IJ, Thompson RK (eds) Pediatric neurosurgery. Blackwell, Oxford, pp 75–98

    Google Scholar 

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Author notes

  1. Ismail L. El-Shafei

    Present address: , 9A, Ahmed Hishmat St., Zamalek, Cairo, Egypt

Authors and Affiliations

  1. Department of Neurosurgery, Manial University Hospital, Cairo University, Cairo, Egypt

    Ismail L. El-Shafei

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  1. Ismail L. El-Shafei
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El-Shafei, I.L. Ventriculojugular shunt against the direction of blood flow. Child's Nerv Syst 3, 342–349 (1987). https://doi.org/10.1007/BF00270704

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