Skip to main content

Examination of Deposits in Cerebrospinal Fluid Shunt Valves Using Scanning Electron Microscopy

  • Conference paper
  • First Online:
Hydrocephalus

Part of the book series: Acta Neurochirurgica Supplementum ((NEUROCHIRURGICA,volume 113))

  • 1803 Accesses

Abstract

Obstruction remains the most common complication of cerebrospinal fluid shunts. The valve constitutes an important site of potential malfunction. The aim of this pilot study was to investigate the extent and composition of debris depositions along the structural components of the shunt valve.

We examined three explanted Medos programmable valves. The valves were stored and examined wet. They were cut open and disassembled. All specimens were studied under a scanning electron microscope (SEM; Quanta 200; FEI, Hillsboro, OR, USA) operating at different levels of accelerating voltage and 110 μA beam current. Valve areas analyzed included the ruby ball and collar, the flat spring with its pillar, and the staircase cam. The elemental composition, in areas with abnormal deposits, was subsequently determined by energy-dispersive X-ray microanalysis (EDS) using a Si (Li) detector (Sapphire; EDAX, Mahwah, NJ, USA) with a super ultrathin Be window.

All explanted valves had varying degrees of deposits in all surveyed areas. The extent of the deposits was not related to the time since implantation. The effect of these deposits on proper functioning of the valve as well as their pathogenesis is difficult to establish.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Browd SR, Gottfield ON, Ragel BT, Kestle JR (2006) Failure of CSF shunts: part I: obstruction and mechanical failure. Pediatr Neurol 34:83–92

    Article  PubMed  Google Scholar 

  2. Brydon HL, Bayston R, Hayward R, Harkness W (1996) Removed shunt valves: reasons for failure and implications for valve design. Br J Neurosurg 10:245–251

    Article  PubMed  CAS  Google Scholar 

  3. Del Bigio MR (1998) Biological reactions to cerebrospinal fluid shunt devices: a review of the cellular pathology. Neurosurgery 42(2):319–325

    Article  PubMed  Google Scholar 

  4. Echizenya K, Satoh M, Murai H et al (1987) Mineralization and biodegradation of CSF shunting systems. J Neurosurg 67:584–591

    Article  PubMed  CAS  Google Scholar 

  5. Gower DJ, Lewis KC, Kelly DL Jr (1984) Sterile shunt malfunction. A scanning electron microscopic perspective. J Neurosurg 61:1079–1084

    Article  PubMed  CAS  Google Scholar 

  6. Griebel RW, Hoffmann HJ, Becker L (1987) Calcium deposits on CSF shunts. Clinical observations and ultrastructural analysis. Childs Nerv Syst 3:180–182

    Article  PubMed  CAS  Google Scholar 

  7. Guevara JA, Zuccaro G, Trevisan A et al (1981) Microscopic studies in shunts for hydrocephalus. Childs Brain 8:284–293

    PubMed  CAS  Google Scholar 

  8. Schoener WF, Reparon C, Verheggen R, Markakis E (1991) Evaluation of shunt failures by compliance analysis and inspection of shunt valves and shunt materials using microscopic or scanning electron microscopic techniques. In: Matsumoto S, Tamaki N (eds) Hydrocephalus: pathogenesis and treatment. Springer, Tokyo, pp 452–472

    Google Scholar 

  9. Sgouros S, Dipple SJ (2004) An investigation of structural degradation of cerebrospinal fluid shunt valves performed using scanning electron microscopy and energy-dispersive x-ray microanalysis. J Neurosurg 100:534–540

    Article  PubMed  Google Scholar 

  10. Zhong Y, Bellamkonda RV (2008) Biomaterials for the central nervous system. J R Soc Interface 5:957–975

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank Prof. G. Iliadis and Dr. S. Zinelis of the Materials Analysis Laboratory of the School of Dentistry of the University of Athens for the substantial help with the technical aspect of this project.

Conflicts of interest statement We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Spyros Sgouros .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag/Wien

About this paper

Cite this paper

Charalambides, C., Sgouros, S. (2012). Examination of Deposits in Cerebrospinal Fluid Shunt Valves Using Scanning Electron Microscopy. In: Aygok, G., Rekate, H. (eds) Hydrocephalus. Acta Neurochirurgica Supplementum, vol 113. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0923-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0923-6_17

  • Published:

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0922-9

  • Online ISBN: 978-3-7091-0923-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics