Challenges During Surgery for Hydrocephalus

  • Inger Aliason
  • Jeffrey L. Koh


Hydrocephalus is caused by excessive ventricular cerebrospinal fluid (CSF), most often resulting in symptoms of increased intracranial pressure (ICP). Surgical management may include placement of a shunt (most commonly ventriculoperitoneal) or endoscopic third ventriculostomy. A thorough preoperative evaluation is essential to identify NPO status, relevant symptoms of increased ICP, and the presence of such comorbidities as latex allergy. Appropriate management of EVD is also important if present. The anesthesiologist needs to be aware of intraoperative complications such as surgical trauma, venous air embolus, and anaphylactic response to latex. Finally, it is not uncommon for patients with a programmable shunt to present for sedated MRI. Appropriate evaluation of the programmable shunt prior to entering the MRI scanner is important to prevent unexpected change in the rate of CSF drainage


Hydrocephalus Slit ventricle syndrome Ventriculostomy Venous air embolism Ventriculoperitoneal shunt External ventricular drain Aspiration Latex allergy 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Inger Aliason
    • 1
  • Jeffrey L. Koh
    • 2
  1. 1.Department of AnesthesiologyPediatric Anesthesiology Associates Medical Group, Valley Children’s HospitalFresnoUSA
  2. 2.Department of Anesthesiology and Perioperative MedicineOregon Health & Science UniversityPortlandUSA

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