Malfunction of V-P Shunt System Equipped with Antisiphon Device in Normal-pressure Hydrocephalus
Three patients with normal-pressure hydrocephalus, who were treated by installation of a low-pressure ventriculo-peritoneal (V-P) shunt system equipped with anti-siphon device, did not show improvement of clinical signs and ventricular size on CT. While,
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Annual Review of Hydrocephalu s
Calcium Deposits on CSF Shunts: Clinical observations and ultrastructural analysis Robert
w.
GRIEBEL,1 Harold J. HOFFMAN ,1 and Laurenee BECKER2
'Division of Neurosurgery and 2Division of Neuropathology, The Hospital for Siek Children, Toronto, Canada
CSF shunts removed from seven patients 5-12 years after placement were studied. Examination in each case revealed gritty mineral deposits adherent to the external surface. The deposits were further analyzed by routine histology, spectroscopy and scanning electron microscopy . Calcium deposition is time related. There is little evidence that infection contributes to the phenomenon or that it is a foreign body or an immune response. Calcification of biomedical prostheses has proven to be a problem in other situations, most notably in cardiovascular prostheses. Calcification of the silicone based pumping diaphragm of the artificial heart has occurred in several species . It has been hypothesized that microbubbles and surface cracks in the prosthetic material serve to accumulate calcium binding proteins or result in the denaturation of trapped proteins creating an environment for subsequent calcification. (Child's Nerv Syst 3: 180-182, 1987) Key words: CSF shunts, Shunt complications, Silicone prosthesis, Scanning electron microscopy, Calcification
Malfunction of V-P Shunt System Equipped with Antisiphon Device in Normal-pressure Hydrocephalus Mitsuru SEIDA, 1 Umeo ITO ,1 Shuichi TOMIDA, 1 Shingo YAMAZAKI,1 and Yutaka INABA2 IDepartment of Neurosurgery, Musashino Red-Cross Hospital; and 2Department of Neurosurgery, Tokyo Medieal and Dental University, Tokyo, Japan
Three patients with normal-pressure hydrocephalus, who were treated by installation of a low-pressure ventriculo-peritoneal (V-P) shunt system equipped with anti-siphon device, did S. Matsumoto et al. (eds.), Annual Review of Hydrocephalus © Springer-Verlag Berlin Heidelberg 1990
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not show improvement of clinical signs and ventricular size on CT . While , the lumbar infusion manometrie test in horizontal patient position showed good function ing of the shunting system in all 3 patient s. However , the clinical signs and ventricular size on CT were remarkably improved by replacing the shunt system to the low pre ssure V-P shunt system which was not equipped with anti-siphon device. The shunt malfunction seemed to be caused by the anti-siphon function itself of the previous shunt system whieh was equ ipped with anti-siphon deviee , especially when the patient s were kept sitting and/or standing during the daily activity. According to Portnoy et al. (1973), once the anti-siphon device was in operation, the ventricular pressure should encounter 1/8 of negative hydrostatic pre ssure which effected distal to the deviee , in order to recanaliz e the closed anti-siphon device. When an adult was kept sitting, negative hydro static pressure of about 800 mmH 20 was effected distal to the device . Therefore, positive hydrostatic pre ssure of more than 100 m
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