The cerebrospinal fluid container is a device for storage of medicaments. By means of surgical operation, a ventricle catheter can be embedded in the ventricle of the brain. This safe and reliable device provides for neurosurgeons a new method of intracranical therapy and reestablishment of the circulating passage of the cerebrospinal fluid.
Brain Diseases ; surgery ; Catheters, Indwelling ; Cerebrospinal Fluid ; Cerebrospinal Fluid Shunts ; instrumentation ; Equipment Design ; Humans ; Neurosurgical Procedures ; instrumentation

Shunting of cerebrospinal fluid into the peritoneal cavity is a well established procedure which has, over the years, enjoyed increasing popularity. A slit valve at the distal end elminated the insinuation of the omentum into the shunting tube and a spring catheter prevented kinking of the shunt tubing. However, the most common cause of failure of the shunting is from the separation, or pulling apart, of the various components of the shunt system with subsequent infection. A one piece spring catheter is sufficient to the necessity. Surgical details are illustrated for installing a one piece spring catheter for hydrocephalus. Four basic steps of surgical procedure using a subcutaneous guide, a leader, a cannula and a cuff are described; firstly passing the guide and the one piece shunt from McBurney's point to the supraclavicular space, secondly passing the guide from the parietal eminence to the supraclavicular space to thread the one piece shunt cephalad. Thirdly, inserting the cannula into the lateral ventricle and threading the ventricular end of the one piece shunt through the cuff into the lateral ventricle and fourthly inserting the peritoneal end into the peritoneal cavity.
Adolescent ; Adult ; Catheterization/methods ; Cerebrospinal Fluid Shunts/instrumentation* ; Cerebrospinal Fluid Shunts/methods ; Child, Preschool ; Human ; Hydrocephalus/surgery ; Infant ; Infant, Newborn ; Peritoneal Cavity

OBJECTIVETo observe the therapeutic effect of Ommaya reservoir implantation on hydrocephalus in premature infants following intraventricular hemorrhage (IVH) and to investigate factors influencing the therapeutic effect.

METHODSAn ambispective cohort study was conducted on the clinical and follow-up data of 20 premature infants (gestational age <32 weeks, birth weight <1500 g) who received Ommaya reservoir implantation because of hydrocephalus following IVH. The therapeutic effect of Ommaya reservoir implantation was observed. These patients were divided into cure and treatment failure groups according to their treatment outcomes. The factors influencing therapeutic effects were investigated by univariate analysis.

RESULTSHydrocephalus was relieved significantly at 30 days after Ommaya reservoir implantation. However, some patients showed significantly decreased therapeutic effects since 3 months after operation: during 3-6 months after operation, 7 cases underwent ventriculoperitoneal shunt, 4 cases discontinued treatment because of economic reasons, and 1 case underwent endoscopic third ventriculostomy due to scalp hematoma with skin necrosis. The ventricles of the remaining 8 cases returned to normal size at 12-18 months after operation. As for postoperative complications, secondary IVH was seen in 8 cases, intracranial infection in 2 cases, and scalp hematoma with skin necrosis in 1 case. The univariate analysis revealed significant differences in gestational age, birth weight and duration of hydrocephalus before Ommaya reservoir implantation between the cure and the treatment failure groups (P<0.05).

CONCLUSIONSOmmaya reservoir implantation has a remarkable short-term therapeutic effect on hydrocephalus in premature infants following IVH, but later the effect decreases in some patients. Low gestational age, low birth weight and long duration of hydrocephalus may be the main factors influencing therapeutic effects of Ommaya reservoir implantation.

Cerebral Hemorrhage ; complications ; Cerebrospinal Fluid Shunts ; instrumentation ; Cohort Studies ; Female ; Humans ; Hydrocephalus ; surgery ; Infant, Newborn ; Infant, Premature ; Male

OBJECTIVETo study the therapeutic effect of mini-traumatic ventriculo-atrial shunt on hydrocephalus.

METHODSSeventeen patients were treated with right internal jugular venepuncture intubation to finish minimally invasive ventriculo-atrial shunt for hydrocephalus. The patients were evaluated by CT/MRI. The catheters were deployed at the proper position in the right atrium under X-ray fluoroscopy.

RESULTSThe hydrocephalus in all the 17 patients eliminated with this surgical procedure with a 100% success rate technically. The operational duration ranged from 0.75 to 1.5 h (average: 1 h). Mistaken puncture into the internal carotid artery as a complication occurred on 1 case.

CONCLUSIONSThe mini-traumatic ventriculo-atrial shunt, as a novel minimal invasion technique, has the advantages of small trauma, no influence on local blood circulation, short time and simplicity at operation, rapid healing, and good short-term effect. Moreover, it is suitable for those patients with organic dysfunction.

Adolescent ; Adult ; Cerebrospinal Fluid Shunts ; instrumentation ; Female ; Heart Atria ; Humans ; Hydrocephalus ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome