Experiences with the anti-siphon device (ASD) in shunt therapy of pediatric hydrocephalus

Restricted access

✓ A follow-up study was performed on 41 hydrocephalic children with primary (10 patients) or secondary (31 patients) placement of an anti-siphon device (ASD) connected to their shunt. The clinical course before and after ASD implantation was compared in these two groups, including studies of the head circumference, the radiological ventricular size, cerebrospinal fluid pressure studies on the supine and upright patient, and the history of shunt-induced complaints and complications leading to hospitalization. The authors discuss the pathophysiological concept of the “chronic overdrainage” or slit-ventricle syndrome based on ventricular collapse due to chronic suction-induced overdrainage by the vertical shunt system in the upright patient. The use of an ASD in connection with the regular shunt system of children with hydrocephalus is proposed. This ASD-shunt combination successfully reduced the number of complaints and shunt dysfunctions over a period of more than 6 years.

Article Information

Contributor Notes

Address reprint requests to: Rolf Gruber, M.D., Oberarzt, Kinderchirurgische Klinik, Kinderspital Basel, Römergasse 8, CH 4005 Basel, Switzerland.

© AANS, except where prohibited by US copyright law.

Headings
References
  • 1.

    Epstein FJFleischer ASHochwald GMet al: Subtemporal craniectomy for recurrent shunt obstruction secondary to small ventricles. J Neurosurg 41:29311974Epstein FJ Fleischer AS Hochwald GM et al: Subtemporal craniectomy for recurrent shunt obstruction secondary to small ventricles. J Neurosurg 41:29–31 1974

    • Search Google Scholar
    • Export Citation
  • 2.

    Fox JLMcCullough DCGreen RC: Effect of cerebrospinal fluid shunts on intracranial pressure and on cerebrospinal fluid dynamics. 2. A new technique of pressure measurements: results and concepts. 3. A concept of hydrocephalus. J Neurol Neurosurg Psychiatry 36:3023121973Fox JL McCullough DC Green RC: Effect of cerebrospinal fluid shunts on intracranial pressure and on cerebrospinal fluid dynamics. 2. A new technique of pressure measurements: results and concepts. 3. A concept of hydrocephalus. J Neurol Neurosurg Psychiatry 36:302–312 1973

    • Search Google Scholar
    • Export Citation
  • 3.

    Fox JLPortnoy HDSchulte RR: Cerebrospinal fluid shunts: an experimental evaluation of flow rates and pressure values in the anti-siphon valve. Surg Neurol 1:2993021973Fox JL Portnoy HD Schulte RR: Cerebrospinal fluid shunts: an experimental evaluation of flow rates and pressure values in the anti-siphon valve. Surg Neurol 1:299–302 1973

    • Search Google Scholar
    • Export Citation
  • 4.

    Giuffrè RPalma LFontana M: Extracranial CSF shunting for infantile non tumoral hydrocephalus — a retrospective analysis of 360 cases. Clin Neurol Neurosurg 81:1992101979Giuffrè R Palma L Fontana M: Extracranial CSF shunting for infantile non tumoral hydrocephalus — a retrospective analysis of 360 cases. Clin Neurol Neurosurg 81:199–210 1979

    • Search Google Scholar
    • Export Citation
  • 5.

    Gruber R: Kritische Betrachtungen zur Hydrozephalus-Therapie anhand des sogenannten “arrested” Hydrozephalus. Z Kinderchir 38:(Suppl):33351983Gruber R: Kritische Betrachtungen zur Hydrozephalus-Therapie anhand des sogenannten “arrested” Hydrozephalus. Z Kinderchir 38 (Suppl):33–35 1983

    • Search Google Scholar
    • Export Citation
  • 6.

    Gruber R: The problem of chronic overdrainage of the ventriculo-peritoneal shunt in congenital hydrocephalus. Z Kinderchir 31:3623691980Gruber R: The problem of chronic overdrainage of the ventriculo-peritoneal shunt in congenital hydrocephalus. Z Kinderchir 31:362–369 1980

    • Search Google Scholar
    • Export Citation
  • 7.

    Gruber R: The relationship of ventricular shunt complications to the chronic overdrainage syndrome: a follow-up study. Z Kinderchir 34:3463521981Gruber R: The relationship of ventricular shunt complications to the chronic overdrainage syndrome: a follow-up study. Z Kinderchir 34:346–352 1981

    • Search Google Scholar
    • Export Citation
  • 8.

    Gruber R: Zur Therapie des kindlichen Hydrozephalus. Ein kritischer Vergleich zwischen ventrikulo-peritonealer und ventrikulo-atrialer Ableitung und deren Komplikationen. Z Kinderchir 28:2122251979Gruber R: Zur Therapie des kindlichen Hydrozephalus. Ein kritischer Vergleich zwischen ventrikulo-peritonealer und ventrikulo-atrialer Ableitung und deren Komplikationen. Z Kinderchir 28:212–225 1979

    • Search Google Scholar
    • Export Citation
  • 9.

    Holness ROHoffman HJHendrick EB: Subtemporal decompression for the slit-ventricle syndrome after shunting in hydrocephalic children. Childs Brain 5:1371441979Holness RO Hoffman HJ Hendrick EB: Subtemporal decompression for the slit-ventricle syndrome after shunting in hydrocephalic children. Childs Brain 5:137–144 1979

    • Search Google Scholar
    • Export Citation
  • 10.

    Hyde-Rowan MDRekate HLNulsen FE: Reexpansion of previously collapsed ventricles: the slit ventricle syndrome. J Neurosurg 56:5365391982Hyde-Rowan MD Rekate HL Nulsen FE: Reexpansion of previously collapsed ventricles: the slit ventricle syndrome. J Neurosurg 56:536–539 1982

    • Search Google Scholar
    • Export Citation
  • 11.

    Keucher TRMealey J Jr: Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:1791861979Keucher TR Mealey J Jr: Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg 50:179–186 1979

    • Search Google Scholar
    • Export Citation
  • 12.

    Little JRRhoton AL JrMellinger JF: Comparison of ventriculoperitoneal and ventriculoatrial shunts for hydrocephalus in children. Mayo Clin Proc 47:3964011972Little JR Rhoton AL Jr Mellinger JF: Comparison of ventriculoperitoneal and ventriculoatrial shunts for hydrocephalus in children. Mayo Clin Proc 47:396–401 1972

    • Search Google Scholar
    • Export Citation
  • 13.

    Lonton AP: The relationship between intellectual skills and the computerised axial tomograms of children with spina bifida and hydrocephalus. Z Kinderchir 28:3683741979Lonton AP: The relationship between intellectual skills and the computerised axial tomograms of children with spina bifida and hydrocephalus. Z Kinderchir 28:368–374 1979

    • Search Google Scholar
    • Export Citation
  • 14.

    Lorber J: Is your brain really necessary in Voth D (ed): Hydrocephalus im frühen Kindesalter. Stuttgart: Enke-Verlag1983 pp 214Lorber J: Is your brain really necessary in Voth D (ed): Hydrocephalus im frühen Kindesalter. Stuttgart: Enke-Verlag 1983 pp 2–14

    • Search Google Scholar
    • Export Citation
  • 15.

    Lorber JPucholt V: When is a shunt no longer necessary? An investigation of 300 patients with hydrocephalus and myelomeningocele: 11–22 year follow up. Z Kinderchir 34:3273291981Lorber J Pucholt V: When is a shunt no longer necessary? An investigation of 300 patients with hydrocephalus and myelomeningocele: 11–22 year follow up. Z Kinderchir 34:327–329 1981

    • Search Google Scholar
    • Export Citation
  • 16.

    McCullough DCFox JL: Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to the production of subdural hematoma. J Neurosurg 40:3723751974McCullough DC Fox JL: Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to the production of subdural hematoma. J Neurosurg 40:372–375 1974

    • Search Google Scholar
    • Export Citation
  • 17.

    Portnoy HDSchulte RRFox JLet al: Anti-siphon and reversible occlusion valves for shunting in hydrocephalus and preventing post-shunt subdural hematomas. J Neurosurg 38:7297381973Portnoy HD Schulte RR Fox JL et al: Anti-siphon and reversible occlusion valves for shunting in hydrocephalus and preventing post-shunt subdural hematomas. J Neurosurg 38:729–738 1973

    • Search Google Scholar
    • Export Citation
  • 18.

    Salah SSunder-Plassmann MZaunbauer Fet al: The use of the anti-siphon-valve in prevention of functional complications of shunting systems in Wüllenweber RWenker HBrock Met al (eds): Treatment of Hydrocephalus. Computer Tomography. Advances in Neurosurgery Vol 6. Berlin/Heidelberg/New York: Springer-Verlag1978 pp 4244Salah S Sunder-Plassmann M Zaunbauer F et al: The use of the anti-siphon-valve in prevention of functional complications of shunting systems in Wüllenweber R Wenker H Brock M et al (eds): Treatment of Hydrocephalus. Computer Tomography. Advances in Neurosurgery Vol 6. Berlin/Heidelberg/New York: Springer-Verlag 1978 pp 42–44

    • Search Google Scholar
    • Export Citation
  • 19.

    Salmon JH: The collapsed ventricle: management and prevention. Surg Neurol 9:3493521978Salmon JH: The collapsed ventricle: management and prevention. Surg Neurol 9:349–352 1978

    • Search Google Scholar
    • Export Citation
  • 20.

    Shucart WAConnolly R: Experimental negative intraventricular pressures. J Surg Res 19:43461975Shucart WA Connolly R: Experimental negative intraventricular pressures. J Surg Res 19:43–46 1975

    • Search Google Scholar
    • Export Citation
TrendMD
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 143 140 6
Full Text Views 148 94 2
PDF Downloads 78 39 2
EPUB Downloads 0 0 0
PubMed
Google Scholar