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An external ventricular drain (EVD), also known as a ventriculostomy or extraventricular drain, is a device used in neurosurgery to treat hydrocephalus and relieve elevated intracranial pressure when the normal flow of cerebrospinal fluid (CSF) inside the brain is obstructed.
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 ...
Thus, it usually does not need insertion of a shunt. If surgical treatment is required, a ventriculoperitoneal shunt is usually preferred. [44] Other treatment options include using medications like acetazolamide. [43] The condition can be diagnosed and monitored with brain sonography and CT/MRI.
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. NPH symptoms reportedly improve in 70–90% of patients with CSF shunt.
A Peritoneovenous shunt: (also called Denver shunt) [2] is a shunt which drains peritoneal fluid from the peritoneum into veins, usually the internal jugular vein or the superior vena cava. It is sometimes used in patients with refractory ascites. It is a long tube with a non-return valve running subcutaneously from the peritoneum to the ...
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 ...
Neurological shunt infections are often caused by skin bacteria such as Cutibacterium acnes, [10] or in instances of ventriculoperitoneal shunts that perforate the gut, by anaerobes of enteric origin (i.e. Bacteroides fragilis). [11] Clostridium perfringens can cause of brain abscesses and meningitis following intracranial surgery or head trauma.