Review: treatment of hydrocephalus in adults.

Hydrocephalus is a major province of neurosurgery because of its high incidence and the still unacceptably high rate of complications that plague all shunting devices (SD). Countless shunts have been designed, some of them rather complex and expensive; however, results continue to be far from satisfactory, indicating that much research is still needed. Hydrocephalus in children is mainly due to congenital abnormalities, whereas hydrocephalus in adults is caused by several different etiopathological conditions; for instance, two frequent forms of primary hydrocephalus in adults are due either to chronic active arachnoiditis or to normotensive hydrocephalus, both of which are almost never seen in children. These two conditions present peculiar challenges for the design of adequate shunting devices. In this review the main aspects of the treatment of hydrocephalus in adults are outlined, stressing principal indications, treatment alternatives, and common complications.

[1]  J. Rosenørn,et al.  The risk of rebleeding from ruptured intracranial aneurysms. , 1987, Journal of neurosurgery.

[2]  E. Laws,et al.  Surgical treatment of idiopathic hydrocephalus in elderly patients , 1985, Neurology.

[3]  S. J. Gaskill,et al.  Pseudocysts of the abdomen associated with ventriculoperitoneal shunts: a report of twelve cases and a review of the literature. , 1989, Pediatric neuroscience.

[4]  N. Gantz,et al.  Intracranial pressure monitors. Epidemiologic study of risk factors and infections. , 1986, The American journal of medicine.

[5]  R. Goodman,et al.  Ventricular volume following third ventriculostomy. , 1999, Journal of neurosurgery.

[6]  L. Auer,et al.  Disturbed cerebrospinal fluid circulation after subarachnoid hemorrhage and acute aneurysm surgery. , 1990, Neurosurgery.

[7]  T. Park,et al.  The treatment of hydrocephalus. , 1993, Neurosurgery clinics of North America.

[8]  H. Hoffman,et al.  Calcium deposits on CSF shunts. Clinical observations and ultrastructural analysis. , 1987, Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery.

[9]  B. Bell,et al.  Comparison of rates of infection of two methods of emergency ventricular drainage. , 1995, Journal of neurology, neurosurgery, and psychiatry.

[10]  R. Delfino,et al.  The relationship of ventricular drainage to aneurysmal rebleeding. , 1992, Journal of neurosurgery.

[11]  C. Ph,et al.  Shunt infections: prevention and treatment. , 1985, Clinical neurosurgery.

[12]  C. Sainte-Rose,et al.  The role of endoscopic third ventriculostomy in the management of shunt malfunction. , 1998, Neurosurgery.

[13]  C. Mulrow,et al.  The value of clinical findings in the detection of normal pressure hydrocephalus. , 1987, Journal of gerontology.

[14]  N. Aoyagi,et al.  Analysis of 223 ruptured intracranial aneurysms with special reference to rerupture. , 1984, Surgical neurology.

[15]  J. Hirsch,et al.  Mechanical complications in shunts. , 1991, Pediatric neurosurgery.

[16]  T. Yamamoto,et al.  Posttraumatic ventriculomegaly: hydrocephalus or atrophy? A new approach for diagnosis using CSF dynamics. , 1996, Journal of neurosurgery.

[17]  P. Camarata,et al.  Dorsal midbrain encephalitis caused by Propionibacterium acnes. Report of two cases. , 1990, Journal of neurosurgery.

[18]  J. Hirsch,et al.  Stenosis of the aqueduct of Sylvius. Etiology and treatment. , 1986, Journal of neurosurgical sciences.

[19]  J. Sotelo,et al.  A new shunt for hydrocephalus that relies on CSF production rather than on ventricular pressure: initial clinical experiences. , 1995, Surgical neurology.

[20]  E. Laws,et al.  New Xenograft Model for Assessing Experimental Therapy of Central Nervous System Tumors: Human Glioblastoma in the Intrathecal Compartment of the Nude Mouse , 1988, Neurosurgery.

[21]  R. Osenbach,et al.  Infections in neurological surgery : diagnosis and management , 1999 .

[22]  F. Vale,et al.  The relationship of subarachnoid hemorrhage and the need for postoperative shunting. , 1997, Journal of neurosurgery.

[23]  N. Aoki,et al.  Avulsion of choroid plexus during revision of ventricular shunting: its high incidence and predictive value on computed tomography scan. , 1990, Surgical neurology.

[24]  H. Portnoy,et al.  Shunts : Are they flow-controlled, pressure-controlled, or neither? , 1999 .

[25]  M. D. Del Bigio,et al.  Short-term response of brain tissue to cerebrospinal fluid shunts in vivo and in vitro. , 1992, Journal of biomedical materials research.

[26]  Z. Jamjoom,et al.  Low Rate of Shunt Revision in Tumoural Obstructive Hydrocephalus , 1998, Acta Neurochirurgica.

[27]  J. Wepsic,et al.  Diuretic synergy in the treatment of acute experimental cerebral edema. , 1971, Journal of neurosurgery.

[28]  M. D. Del Bigio,et al.  Reaction of periventricular tissue in the rat fourth ventricle to chronically placed shunt tubing implants. , 1986, Neurosurgery.

[29]  D. Horton,et al.  Fluid flow performance of a new siphon-control device for ventricular shunts. , 1990, Journal of neurosurgery.

[30]  K. Wester,et al.  Shunt failures and complications in adults as related to shunt type, diagnosis, and the experience of the surgeon. , 1994, Neurosurgery.

[31]  G. Morley ASBESTOS IN THE AIR , 1976, The Lancet.

[32]  J. Chandler,et al.  Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter. , 1997, Journal of neurosurgery.

[33]  P. Vondracek,et al.  Biostability of medical elastomers: a review. , 1984, Biomaterials.

[34]  J. Hirsch Percutaneous Ventriculocisternostomies in Non-Communicating Hydrocephalus , 1982 .

[35]  J. Drake,et al.  Imaging correlates of successful endoscopic third ventriculostomy. , 2000, Journal of neurosurgery.

[36]  Buddy D. Ratner,et al.  Chapter 8 Characterization of biomaterial surfaces , 1993 .

[37]  J. Moossy,et al.  Malfunctioning ventriculoperitoneal shunts. Clinical and pathological features. , 1982, Journal of neurosurgery.

[38]  U. Bogdahn,et al.  Continuous-pressure controlled, external ventricular drainage for treatment of acute hydrocephalus--evaluation of risk factors. , 1992, Neurosurgery.

[39]  B. Walters,et al.  Antibiotic prophylaxis for cerebrospinal fluid shunts: a metanalysis. , 1994, Neurosurgery.

[40]  D. Levy,et al.  Discitis caused by the Centers for Disease Control microorganism Group Ve-1. , 1989, Neurosurgery.

[41]  E. Benzel,et al.  Communicating hydrocephalus in adults: Prediction of outcome after ventricular shunting procedures , 1990 .

[42]  H. Kasuya,et al.  The effect of continuous drainage of cerebrospinal fluid in patients with subarachnoid hemorrhage: a retrospective analysis of 108 patients. , 1991, Neurosurgery.

[43]  J. Sotelo,et al.  Treatment of hydrocephalus in adults by placement of an open ventricular shunt. , 2001, Journal of neurosurgery.

[44]  H. Hoffman,et al.  Calcium deposits on CSF shunts , 1987, Child's Nervous System.

[45]  R. Snow,et al.  Clinical-pathological analysis of failed central nervous system fluid shunts. , 1989, Journal of biomedical materials research.

[46]  D. Jimenez,et al.  Epidemiology of cerebrospinal fluid shunting. , 1995, Pediatric neurosurgery.

[47]  C. Sainte-Rose,et al.  Shunt obstruction: a preventable complication? , 1993, Pediatric neurosurgery.

[48]  J. Piatt,et al.  A search for determinants of cerebrospinal fluid shunt survival: retrospective analysis of a 14-year institutional experience. , 1993, Pediatric neurosurgery.

[49]  J W Eaton,et al.  Inflammatory responses to biomaterials. , 1995, American journal of clinical pathology.

[50]  R. Pudenz,et al.  Hydrocephalus: overdrainage by ventricular shunts. A review and recommendations. , 1991, Surgical neurology.

[51]  D. Mclone,et al.  Third ventriculostomy: a review. , 1997, Surgical neurology.

[52]  J. Sotelo,et al.  Effects of prednisone on ventriculoperitoneal shunt function in hydrocephalus secondary to cysticercosis: a preliminary study. , 1996, Journal of neurosurgery.

[53]  J. Tans,et al.  The Dutch Normal-Pressure Hydrocephalus Study , 2000 .

[54]  N. Hopf,et al.  Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. , 1999, Neurosurgery.

[55]  Aul,et al.  The significance of bacteriologically positive ventriculoperitoneal shunt components in the absence of other signs of shunt infection. , 1996, Journal of Neurosurgery.

[56]  F. Brunelle,et al.  Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. , 1999, Neurosurgical focus.

[57]  R. Yogev Cerebrospinal fluid shunt infections: a personal view. , 1985, Pediatric infectious disease.

[58]  B. Walters,et al.  Cerebrospinal fluid shunt infection. Influences on initial management and subsequent outcome. , 1984, Journal of neurosurgery.

[59]  H. Abe,et al.  Mineralization and biodegradation of CSF shunting systems. , 1987, Journal of neurosurgery.

[60]  R. Jones,et al.  The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. , 1994, Minimally invasive neurosurgery : MIN.

[61]  Ó. Suárez-Rivera Acute hydrocephalus after subarachnoid hemorrhage. , 1998, Surgical neurology.

[62]  D. Williams,et al.  Immune response in biocompatibility. , 1992, Biomaterials.

[63]  Venes Jl Infections of CSF shunt and intracranial pressure monitoring devices. , 1989 .

[64]  J. Campbell,et al.  Complications in ventricular cerebrospinal fluid shunting. , 1993, Neurosurgery clinics of North America.

[65]  L. Goumnerova,et al.  Telemetric intraventricular pressure measurements after third ventriculocisternostomy in a patient with noncommunicating hydrocephalus. , 1997, Neurosurgery.

[66]  K. Elisevich,et al.  Biodegradation of distal shunt catheters. , 1994, Pediatric neurosurgery.

[67]  F. Loew,et al.  Burr hole third ventriculo-cisternostomy. An unpopular but effective procedure for treatment of certain forms of occlusive hydrocephalus. , 1986, Acta neurochirurgica.

[68]  J. Hirsch,et al.  Factors causing acute shunt infection. Computer analysis of 1174 operations. , 1984, Journal of neurosurgery.

[69]  N. Rainov,et al.  Ultrasound-guided endoscopic fenestration of the third ventricular floor for non-communicating hydrocephalus. , 1996, Minimally invasive neurosurgery : MIN.

[70]  R. Blasberg,et al.  Absorption resistance of cerebrospinal fluid after subarachnoid hemorrhage in the monkey; effects of heparin. , 1981, Neurosurgery.

[71]  H. Adams,et al.  Factors associated with hydrocephalus after subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study. , 1989, Archives of neurology.

[72]  H. Portnoy,et al.  Anti-siphon and reversible occlusion valves for shunting in hydrocephalus and preventing post-shunt subdural hematomas. , 1973, Journal of neurosurgery.

[73]  R. Goodman,et al.  Third ventriculostomy: post-operative ventricular size and outcome. , 1996, Minimally invasive neurosurgery : MIN.

[74]  T. Dóczi,et al.  Disturbances of cerebrospinal fluid circulation during the acute stage of subarachnoid hemorrhage. , 1983, Neurosurgery.

[75]  Taptas Jn,et al.  Communicating hydrocephalus in adults , 1968 .

[76]  J D Pickard,et al.  Testing of cerebrospinal compensatory reserve in shunted and non-shunted patients: a guide to interpretation based on an observational study. , 1996, Journal of neurology, neurosurgery, and psychiatry.

[77]  J. Drake,et al.  The shunt book , 1995 .

[78]  M. Gangemi,et al.  Endoscopic surgery for monoventricular hydrocephalus. , 1999, Surgical neurology.

[79]  W. Zingg,et al.  Human erythrocyte adhesion and spreading on protein-coated polymer surfaces. , 1989, Journal of biomedical materials research.

[80]  J Hermans,et al.  Dutch normal-pressure hydrocephalus study: prediction of outcome after shunting by resistance to outflow of cerebrospinal fluid. , 1997, Journal of neurosurgery.

[81]  D. Shurtleff,et al.  Experience with 1201 cerebrospinal fluid shunt procedures. , 1985, Pediatric neuroscience.

[82]  B. Romner,et al.  Seven years of clinical experience with the programmable Codman Hakim valve: a retrospective study of 583 patients. , 2000, Journal of neurosurgery.

[83]  J. Drake,et al.  Brain biomechanics: Mathematical modeling of hydrocephalus , 2000, Neurological research.

[84]  M. Yamamoto,et al.  Flexible endoneurosurgical therapy for aqueductal stenosis. , 1993, Neurosurgery.

[85]  D. Hasan,et al.  Distribution of cisternal blood in patients with acute hydrocephalus after subarachnoid hemorrhage , 1992, Annals of neurology.

[86]  J. Drake,et al.  Efficacy of antimicrobial prophylaxis in placement of cerebrospinal fluid shunts: meta-analysis. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[87]  J. Hirsch,et al.  Pericerebral collections after shunting , 2004, Child's Nervous System.

[88]  J. Kristiansen,et al.  Antibiotic prophylaxis in cerebrospinal fluid shunting: a prospective randomized trial in 152 hydrocephalic patients. , 1985, Neurosurgery.

[89]  T. Inagawa,et al.  Chronic hydrocephalus in elderly patients following subarachnoid hemorrhage. , 2000, Surgical neurology.

[90]  Ian F. Pollack,et al.  A Randomized, Controlled Study of a Programmable Shunt Valve versus a Conventional Valve for Patients with Hydrocephalus , 1999 .

[91]  J. Galicich,et al.  Formation and absorption of cerebrospinal fluid in man. , 1968, Brain : a journal of neurology.

[92]  E. Wijdicks,et al.  Management problems in acute hydrocephalus after subarachnoid hemorrhage. , 1989, Stroke.

[93]  J. Mealey,et al.  Origin of Organisms Infecting Ventricular Shunts , 1988, Neurosurgery.

[94]  Del Bigio Mr Biological Reactions to Cerebrospinal Fluid Shunt Devices: A Review of the Cellular Pathology , 1998 .

[95]  S. Ashkenazi BACTERIAL ADHERENCE TO PLASTICS , 1984, The Lancet.

[96]  M. Gourdeau,et al.  CSF Shunt Infections: A Fifteen-Year Experience with Emphasis on Management and Outcome , 1993, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[97]  D. Harwood-Nash,et al.  Percutaneous third ventriculostomy in the management of noncommunicating hydrocephalus. , 1980, Neurosurgery.

[98]  M. Brydon,et al.  Endoscopic third ventriculostomy. , 1990, Neurosurgery.

[99]  J D Pickard,et al.  Posture-related overdrainage: comparison of the performance of 10 hydrocephalus shunts in vitro. , 1998, Neurosurgery.

[100]  T. Nishioka,et al.  Calcification of a ventriculoperitoneal shunt tube. Case report. , 1988, Surgical neurology.

[101]  R. Yogev,et al.  Ventriculoperitoneal shunt infections with gram-negative bacteria. , 1993, Neurosurgery.

[102]  P. Black,et al.  The Importance of “Accessory” Outflow Pathways in Hydrocephalus after Experimental Subarachnoid Hemorrhage , 1989 .

[103]  R. Jones,et al.  Third Ventriculostomy for Hydrocephalus Associated with Spinal Dysraphism: Indications and Contraindications , 1996, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[104]  R. Bayston,et al.  Duration of protective activity of cerebrospinal fluid shunt catheters impregnated with antimicrobial agents to prevent bacterial catheter-related infection. , 1997, Journal of neurosurgery.

[105]  H. Portnoy,et al.  Shunts: which one, and why? , 1998, Surgical neurology.

[106]  R. Jones,et al.  Neuroendoscopic third ventriculostomy. A practical alternative to extracranial shunts in non-communicating hydrocephalus. , 1994, Acta neurochirurgica. Supplement.

[107]  H. Stiver,et al.  Cerebrospinal fluid shunt infections. A review of 35 infections in 32 patients. , 1983, Journal of neurosurgery.

[108]  H. Kontos,et al.  Pial arteriolar vessel diameter and CO2 reactivity during prolonged hyperventilation in the rabbit. , 1988, Journal of neurosurgery.

[109]  J. Sotelo,et al.  Differences between ventricular and lumbar cerebrospinal fluid in hydrocephalus secondary to cysticercosis. , 1995, Neurosurgery.

[110]  Michael A. Williams,et al.  Silicone elastomer cerebrospinal fluid shunt systems , 1998 .

[111]  R. Hayward,et al.  Infection of cerebrospinal fluid shunts in infants: a study of etiological factors. , 1992, Journal of neurosurgery.

[112]  E. Cosman,et al.  The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study. , 1990, Neurosurgery.

[113]  L. Baddour,et al.  Phenotypic variation of Staphylococcus epidermidis slime production in vitro and in vivo , 1987, Infection and immunity.

[114]  Gardner C. Pierce,et al.  Infections of central nervous system shunts. , 1985 .

[115]  M. Choux,et al.  Shunt implantation: reducing the incidence of shunt infection. , 1992, Journal of neurosurgery.

[116]  P. Kelly Stereotactic third ventriculostomy in patients with nontumoral adolescent/adult onset aqueductal stenosis and symptomatic hydrocephalus. , 1991, Journal of neurosurgery.

[117]  J. Drake Ventriculostomy for treatment of hydrocephalus. , 1993, Neurosurgery clinics of North America.

[118]  J. Bean,et al.  Prospective randomized study of therapy in cerebrospinal fluid shunt infection. , 1980, Neurosurgery.