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The treatment of choice in NPH is ventriculoperitoneal shunt surgery (VPS). This treatment needs a VP shunt, which is a catheter with a valve aiming at implementing a one-way outflow of the excessive amount of CSF from the ventricles. It is obligatory to have patency control because of some possible complications such as infections and obstruction.
ShuntCheck is comparable to imaging in ruling out shunt obstruction in cases which the Attending Physician judges to be “unlikely to require shunt surgery”. Sinai Baltimore NPH Study 2012-2014 Michael A. Williams MD is conducting ShuntCheck testing on adult hydrocephalus patients undergoing radionuclide shunt patency testing.
Diagram demonstrating surgical placement of a VP shunt used to manage NPH. For suspected cases of NPH, CSF shunting is the first-line treatment. The most common type used to treat NPH is ventriculoperitoneal (VP) shunts, which drain CSF fluid to the peritoneal cavity. Adjustable valves allow fine-tuning of CSF drainage.
To evaluate the benefit of surgical shunt removal or externalization followed by removal, Wong et al. compared two groups: one with medical treatment alone, and another with medical and surgical treatment simultaneously. 28 patients with infection after ventriculoperitoneal shunt implantation over an 8-year period in their neurosurgical center ...
The shunt also has a valve which serves to maintain one-way flow of the CSF and regulates the flow rate. The end with the catheter is placed in the third ventricle to drain the excess CSF and the other end is placed in the peritoneal cavity or atrium of the heart (making it a ventriculoperitoneal or ventriculoatrial shunt, respectively). The ...
Resistance to traditional analgesic pharmacological therapy may also be a sign of shunt overdrainage or failure. [49] Following placement of a ventriculoperitoneal shunt there have been cases of a decrease in post-surgery hearing. It is presumed that the cochlea aqueduct is responsible for the decrease in hearing thresholds.
Shunt surgery was introduced in 1949; initially, ventriculoperitoneal shunts were used. In 1971, good results were reported with lumboperitoneal shunting. Negative reports on shunting in the 1980s led to a brief period (1988–1993) during which optic nerve fenestration (which had initially been described in an unrelated condition in 1871) was ...
Each of the types of shunts listed above can be composed of a tube or catheter and various types of valves, although they can just be composed of the tubing or catheter. Below is a list of valves that are used in lumbar–peritoneal shunts (LP shunts) and Cerebral shunts (for a more detailed list of the types of valves see type of valves): Delta