Hydrodynamic properties of hydrocephalus shunts. 1998

Z Czosnyka, and M Czosnyka, and H Richards, and J D Pickard
U.K. Shunt Evaluation Laboratory, Addenbrooke's Hospital, Cambridge, U.K.

Hydrodynamic properties of hydrocephalus shunts are not always properly characterized by the manufacturer. Therefore, the choice of the shunt should be made, by matching performance of the shunt to the disturbed profile of CSF circulation of a given patient. The aim of the present shunt evaluation study is to evaluates all types of shunts presently in use in the U.K. and make this information available to neurosurgeons. Ten most common models of valves have been tested to date: Medtronik PS Medical: Delta Valve, Flow Control Valves and Lumbo-Peritoneal Shunt, Heyer-Schulte: In-line, Low Profile and Pudenz Flushing Valve, Codman: Medos-Programmable, Hakim-Precision, Sophy Programmable Valve, Cordis Orbis-Sigma. Our results show the majority of valves have low hydrodynamic resistance (exception: PS Lumboperitoneal, Orbis-Sigma), which increase by 100-200% after connection of a long distal catheter. A few shunts with siphon-preventing mechanism (Delta, Hayer-Schulte Low Profile, Pudenz-Flushing) offer reasonable resistance to negative outlet pressures, however, these valves may be blocked by raised subcutaneous pressure. All programmable valves are susceptible to siphoning. Programmed settings may be changed by external magnetic field.

UI MeSH Term Description Entries
D007427 Intracranial Pressure Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D002557 Cerebrospinal Fluid Shunts Tubes inserted to create communication between a cerebral ventricle and the internal jugular vein. Their emplacement permits draining of cerebrospinal fluid for relief of hydrocephalus or other condition leading to fluid accumulation in the ventricles. Cerebrospinal Fluid Shunt,Shunt, Cerebrospinal Fluid,Shunts, Cerebrospinal Fluid
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006849 Hydrocephalus Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, INTRACRANIAL HYPERTENSION; HEADACHE; lethargy; URINARY INCONTINENCE; and ATAXIA. Communicating Hydrocephalus,Congenital Hydrocephalus,Obstructive Hydrocephalus,Post-Traumatic Hydrocephalus,Aqueductal Stenosis,Cerebral Ventriculomegaly,Fetal Cerebral Ventriculomegaly,Hydrocephalus Ex-Vacuo,Hydrocephaly,Aqueductal Stenoses,Cerebral Ventriculomegalies,Cerebral Ventriculomegalies, Fetal,Cerebral Ventriculomegaly, Fetal,Fetal Cerebral Ventriculomegalies,Hydrocephalus Ex Vacuo,Hydrocephalus Ex-Vacuos,Hydrocephalus, Communicating,Hydrocephalus, Congenital,Hydrocephalus, Obstructive,Hydrocephalus, Post-Traumatic,Post Traumatic Hydrocephalus,Stenoses, Aqueductal,Stenosis, Aqueductal,Ventriculomegalies, Cerebral,Ventriculomegalies, Fetal Cerebral,Ventriculomegaly, Cerebral,Ventriculomegaly, Fetal Cerebral
D015170 Cerebrospinal Fluid Pressure Manometric pressure of the CEREBROSPINAL FLUID as measured by lumbar, cerebroventricular, or cisternal puncture. Within the cranial cavity it is called INTRACRANIAL PRESSURE. Spinal Fluid Pressure,Cerebrospinal Fluid Pressures,Pressure, Cerebrospinal Fluid,Pressures, Cerebrospinal Fluid,Fluid Pressure, Cerebrospinal,Fluid Pressure, Spinal,Fluid Pressures, Cerebrospinal,Fluid Pressures, Spinal,Pressure, Spinal Fluid,Pressures, Spinal Fluid,Spinal Fluid Pressures
D017287 Ventriculoperitoneal Shunt Surgical creation of a communication between a cerebral ventricle and the peritoneum by means of a plastic tube to permit drainage of cerebrospinal fluid for relief of hydrocephalus. (From Dorland, 28th ed) Ventriculo-peritoneal Shunt,Shunt, Ventriculo-peritoneal,Shunt, Ventriculoperitoneal,Shunts, Ventriculo-peritoneal,Shunts, Ventriculoperitoneal,Ventriculo peritoneal Shunt,Ventriculo-peritoneal Shunts,Ventriculoperitoneal Shunts
D019544 Equipment Failure Analysis The evaluation of incidents involving the loss of function of a device. These evaluations are used for a variety of purposes such as to determine the failure rates, the causes of failures, costs of failures, and the reliability and maintainability of devices. Materials Failure Analysis,Prosthesis Failure Analysis,Analysis, Equipment Failure,Analysis, Materials Failure,Analysis, Prosthesis Failure,Analyses, Equipment Failure,Analyses, Materials Failure,Analyses, Prosthesis Failure,Equipment Failure Analyses,Failure Analyses, Equipment,Failure Analyses, Materials,Failure Analyses, Prosthesis,Failure Analysis, Equipment,Failure Analysis, Materials,Failure Analysis, Prosthesis,Materials Failure Analyses,Prosthesis Failure Analyses

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