Ventriculo-venous shunt to the proximal segment of an occluded neck vein. A new method for shunting the cerebrospinal fluid to the venous circulation

Abstract

During the past four years, 36 hydrocephalic patients were treated by shunting the cerebrospinal fluid (CSF) to the proximal segment of an occluded neck vein. When the CSF is shunted in this fashion it takes a complex pathway back to the heart. During its flow to the venous circulation, the CSF washes the blood away from the vein and converts it into an extension of the shunting catheter. The CSF that continuoussly fills the vein forms a barrier which separates the shunting tube from the circulating blood and prevents blood clotting around the end of the tube. Observations revealed that the intraventricualr pressure was maintained within normal limits, no siphonage effect developed when the patient assumed a sitting position, and reflux of blood into the shunting catheter did not occur. Valveless catheters were used in the first 29 patients; in the last seven patients, specially designed valved catheters were used.