Abstract
Overdrainage of cerebrospinal fluid is one of the most frequent complications of shunting and linked to a series of complications including slit-ventricle syndrome, postshunt craniosynostosis, subdural hematomas, and intermittent catheter obstruction. Although complications of overdrainage are well represented in the literature and there have been many recent advancements in the treatment of these conditions by means of technological devices such as adjustable valves and other surgical techniques including subtemporal craniectomy and endoscopic techniques, it remains a management dilemma. Currently, there are no exact criteria for identifying susceptible patients who will develop overdrainage. Further studies are needed to understand the complex pathophysiology of these complications before making a proper scientific decision. In this chapter, we have analyzed the etiology, physiopathology, clinical picture, diagnosis, and management of these complications comprehensively.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tschan CA, Antes S, Huthmann A, Vulcu S, Oertel J, Wagner W (2014) Overcoming CSF overdrainage with the adjustable gravitational valve proSA. Acta Neurochir (Wien) 156(4):767–776
Faulhauer K, Schmitz P (1978) Overdrainage phenomena in shunt treated hydrocephalus. Acta Neurochir (Wien) 45(1–2):89–101
Browd SR, Gottfried ON, Ragel BT, Kestle JR (2006) Failure of cerebrospinal fluid shunts: part II: overdrainage, loculation, and abdominal complications. Pediatr Neurol 34(3):171–176
Cheok S, Chen J, Lazareff J (2014) The truth and coherence behind the concept of overdrainage of cerebrospinal fluid in hydrocephalic patients. Childs Nerv Syst 30(4):599–606
Becker DP, Nulsen FE (1968) Control of hydrocephalus by valve-regulated venous shunt: avoidance of complications in prolonged shunt maintenance. J Neurosurg 28(3):215–226
Pudenz RH, Foltz EL (1991) Hydrocephalus: overdrainage by ventricular shunts. A review and recommendations. Surg Neurol 35(3):200–212
Aschoff A, Kremer P, Benesch C, Fruh K, Klank A, Kunze S (1995) Overdrainage and shunt technology. A critical comparison of programmable, hydrostatic and variable-resistance valves and flow-reducing devices. Childs Nerv Syst 11(4):193–202
Portnoy HD, Schulte RR, Fox JL, Croissant PD, Tripp L (1973) Anti-siphon and reversible occlusion valves for shunting in hydrocephalus and preventing post-shunt subdural hematomas. J Neurosurg 38(6):729–738
Chapman PH, Cosman ER, Arnold MA (1990) The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study. Neurosurgery 26(2):181–189
Kurtom KH, Magram G (2007) Siphon regulatory devices: their role in the treatment of hydrocephalus. Neurosurg Focus 22(4):E5
Drake JM, Kestle JR, Milner R, Cinalli G, Boop F, Piatt J Jr, Haines S, Schiff SJ, Cochrane DD, Steinbok P, MacNeil N (1998) Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery 43(2):294–303
Bergsneider M, Miller C, Vespa PM, Hu X (2008) Surgical management of adult hydrocephalus. Neurosurgery 62(Suppl 2):643–659
Boon AJ, Tans JT, Delwel EJ, Egeler-Peerdeman SM, Hanlo PW, Wurzer HA, Avezaat CJ, de Jong DA, Gooskens RH, Hermans J (1998) Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts. J Neurosurg 88(3):490–495
Larysz D, Larysz P, Klimczak A, Mandera M (2010) Is neuroradiological imaging sufficient for exclusion of intracranial hypertension in children? Intracranial hypertension syndrome without evident radiological symptoms. Acta Neurochir Suppl 106:203–208
Di Rocco C, Marchese E, Velardi F (1994) A survey of the first complication of newly implanted CSF shunt devices for the treatment of nontumoral hydrocephalus. Cooperative survey of the 1991–1992 Education Committee of the ISPN. Childs Nerv Syst 10(5):321–327
Rekate HL (1993) Classification of slit-ventricle syndromes using intracranial pressure monitoring. Pediatr Neurosurg 19(1):15–20
Rekate HL (2008) Shunt-related headaches: the slit ventricle syndromes. Childs Nerv Syst 24(4):423–430
Kestle J, Drake J, Milner R, Sainte-Rose C, Cinalli G, Boop F, Piatt J, Haines S, Schiff S, Cochrane D, Steinbok P, MacNeil N (2000) Long-term follow-up data from the Shunt Design Trial. Pediatr Neurosurg 33(5):230–236
Vernet O, Campiche R, de Tribolet N (1995) Long-term results after ventriculo-atrial shunting in children. Childs Nerv Syst 11(3):176–179
Major O, Fedorcsák I, Sipos L, Hantos P, Kónya E, Dobronyi I, Paraicz E (1994) Slit-ventricle syndrome in shunt operated children. Acta Neurochir (Wien) 127(1–2):69–72
Sgouros S, Malluci C, Walsh AR, Hockley AD (1995) Long-term complications of hydrocephalus. Pediatr Neurosurg 23(3):127–132
Serlo W, Saukkonen AL, Heikkinen E, von Wendt L (1989) The incidence and management of the slit ventricle syndrome. Acta Neurochir (Wien) 99(3–4):113–116
Fattal-Valevski A, Beni-Adani L, Constantini S (2005) Short-term dexamethasone treatment for symptomatic slit ventricle syndrome. Childs Nerv Syst 21(11):981–984
Chernov MF, Kamikawa S, Yamane F, Ishihara S, Hori T (2005) Neurofiberscope-guided management of slit-ventricle syndrome due to shunt placement. J Neurosurg 102(3 Suppl):260–267
Yelin FS, Ehni G (1969) Percallosal sump ventriculostomy for shunt-dependent hydrocephalic patient with small ventricles. Case report. J Neurosurg 31(5):570–573
Epstein FJ, Fleischer AS, Hochwald GM, Ransohoff J (1974) Subtemporal craniectomy for recurrent shunt obstruction secondary to small ventricles. J Neurosurg 41(1):29–31
Papadakis N, Epstein F (1975) Letter: subtemporal craniectomy for recurrent shunt obstruction. J Neurosurg 42(1):115–117
Roth J, Biyani N, Udayakumaran S, Xiao X, Friedman O, Beni-Adani L, Constantini S (2011) Modified bilateral subtemporal decompression for resistant slit ventricle syndrome. Childs Nerv Syst 27(1):101–110
Reddy K, Fewer HD, West M, Hill NC (1988) Slit ventricle syndrome with aqueduct stenosis: third ventriculostomy as definitive treatment. Neurosurgery 23(6):756–759
Cohen I (1949) Third ventriculostomy proven patent after 15 years. J Neurosurg 6(1):89–94
Gruber R, Jenny P, Herzog B (1984) Experiences with the anti-siphon device (ASD) in shunt therapy of pediatric hydrocephalus. J Neurosurg 61(1):156–162
McLaurin RL, Olivi A (1987) Slit-ventricle syndrome: review of 15 cases. Pediatr Neurosci 13(3):118–124
Boschert JM, Krauss JK (2006) Endoscopic third ventriculostomy in the treatment of shunt-related over-drainage: Preliminary experience with a new approach how to render ventricles navigable. Clin Neurol Neurosurg 108(2):143–149
Weinzweig J, Bartlett SP, Chen JC, Losee J, Sutton L, Duhaime AC, Whitaker LA (2008) Cranial vault expansion in the management of postshunt craniosynostosis and slit ventricle syndrome. Plast Reconstr Surg 122(4):1171–1180
Strenger L (1963) Complications of ventriculovenous shunts. J Neurosurg 20:219–224
Doorenbosch X, Molloy CJ, David DJ, Santoreneos S, Anderson PJ (2009) Management of cranial deformity following ventricular shunting. Childs Nerv Syst 25(7):871–874
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Kalkan, E., Kaya, B., Erdi, F., Turgut, A.T. (2015). Functional Complications: Hyperdrainage. In: Di Rocco, C., Turgut, M., Jallo, G., Martínez-Lage, J. (eds) Complications of CSF Shunting in Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-319-09961-3_7
Download citation
DOI: https://doi.org/10.1007/978-3-319-09961-3_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-09960-6
Online ISBN: 978-3-319-09961-3
eBook Packages: MedicineMedicine (R0)