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ventriculostomy; ventricular shunt

Indications: - hydrocephalus Procedure: - establishment of an opening in a cerebral ventricle, generally through the floor of the 3rd ventricle into the subarachnoid space - CSF may be shunted to the - peritoneal cavity (ventriculoperitoneal shunt) - interpeduncular cistern (ventriculocisternostomy) - right atrium [3] - jugular vein [3] - antibiotic-impregnated catheters reduce risk of infection (NNT*= 11) more effectively than systemic antibiotics (NNT=20) [5] * NNT = number needed to treat to prevent 1 infection

Specific

ventriculo-atrial/jugular shunt ventriculocisternostomy ventriculoperitoneal (VP) shunt

General

cerebrospinal fluid shunt

References

  1. Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
  2. Encyclopedia of Surgery: Ventricular shunt http://www.surgeryencyclopedia.com/St-Wr/Ventricular-Shunt.html
  3. CPT
  4. Sells CF and Shurtleff DB Cerebrospinal Fluid Shunts West J Med. 1977 August; 127(2): 93-98 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1237715/?page=1
  5. The NNT: Antibiotics for Infection Prevention With Intracranial Ventricular Shunt Placement. http://www.thennt.com/nnt/antibiotics-for-infection-prevention-in-ventricular-shunt-placement/ - Ratilal B, Costa J, Sampaio C. Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts: a systematic review. J Neurosurg Pediatr. 2008 Jan;1(1):48-56 PMID: 18352803 - Ratilal B, Costa J, Sampaio C Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunt. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD005365. PMID: 16856095