Ventriculojugular Shunt against the Direction of Blood Flow, III: Operative technique and results
One hundred hydrocephalic patients were treated by shunting the cerebrospinal fluid (CSF) to the internal jugular vein (IJV) against the direction of blood flow. The shunting catheter was introduced into the IJV via the common facial vein (CFV). In the la
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Ventriculojugular Shunt against the Direction of Blood Flow, 111: Operative technique and results Ismail L. EL-SHAFEI Department of Neurosurgery , Manial University Hospital , Cairo University, Cairo , Egypt
One hundred hydrocephalic patients were treated by shunting the cerebrospinal fluid (CSF) to the internal jugular vein (UV) against the direction of blood flow. The shunting catheter was introduced into the UV via the common facial vein (CFV) . In the last 20 patients, the course of the CFV was changed to make it pass upwards , instead of downwards , to join the UV. The patients were divided into two groups . Group I included 68 patients with rigid craniums. Group 11 included 32 infants with compressible craniums. Four patients died , eleven patients had their shunting catheters removed due to infection and the shunt was revised in 12 patients. None of the deaths , complic ations or revisions were considered related to the dynamics of the shunt. 82 patients ben efited from the shunt , 9 of them after shunt revision . In pati ents with rigid craniums, shunt implantation was easy and the postoper ative improvement was satisfactory, both clinically and radiologically. The amount of reduction in the size of the ventricles was inversel y proportional to the degree of postop er ative vent ricular dilatation. In infants with compressible craniums, shunt implantation was difficult due to the thin caliber of the neck veins, the clinical improvem ent was satisfactory although the head circumference continued to increase at a slower rate than before surgery and there was minimal reduction in the ventriculome galy. (Child' s Nerv Syst 3: 342-349,1987) Key words: Hydroc ephalus, Intracranial Pre ssur e, Cerebrospinal fluid shunts, Ventriculovenous shunts, Catheter again st blood flow
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1
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2
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S. Matsumoto et al. (eds.), Annual Review of Hydrocephalus © Springer-Verlag Berlin Heidelberg 1990
Figure. Ven triculoju gular shunt against blood flow. IJV: Intern al jugula r vein. CFV: Common facial vein after changing its course. ST: Side tub e. PI: Plug. Ligs. 1, 2, 3, 4, 5, 6: Ligatu res for shunt fixation.
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