Section 4 - Treatment and outcomes

Summary

This chapter describes many of the techniques and protocols that can be used to minimize the risk of shunt failure, focusing on the surgical procedure at each anatomic location for proximal and distal catheter placement. It includes the extended discussions of ventricular and lumbar proximal catheters, and peritoneal, atrial, pleural, and other distal catheters. Valves can be divided into four different categories: differential pressure valves, flow-regulated valves, antisiphon valves, and adjustable valves. Antisiphon valves are used to prevent the siphoning of cerebrospinal fluid (CSF) into the distal compartment. Antisiphon devices (ASDs) are primarily used in management of normal pressure hydrocephalus (NPH) patients in the adult population to prevent the formation of subdural hematomas and hygromas, and in the management of hydrocephalus in the pediatric population to prevent the slit ventricle syndrome and proximal catheter obstruction.