Preliminary Experiences with the Spitz‐Holter Ventriculo‐Caval Shunt in the Treatment of Hydrocephalus1

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Abstract
Summary: A preliminary report is given of 5 cases of infantile hydrocephalus where ventriculo‐venous shunt operations using the Spitz‐Holter technique were performed. There were no postoperative deaths. In all cases pre‐ and postoperative measurements of head circumference, pneu‐mography of the ventricular system, recordings of the ventricular fluid pressure and examinations by pediatricians with regard to mental and physical development were performed. The follow‐up time ranged between 6 and 12 months. Three reoperations of the shunt were necessary in two patients, after which all valves were functioning well. In all 5 cases interruption of the rapid increase in the head circumference occurred and a low ventricular fluid pressure was found postopera‐tively. In 4 cases postoperative pneumo‐graphy suggested an incress? in brain bulk. Normal mental development was found in 4 of the cases.In addition a brief report is given of a case of increased intracranial pressure due to diffuse melanosarcomatosis of the meninges in an adult. In this case a Spitz‐Holter shunt operation reduced a preoperatively high and widely fluctuating ventricular fluid pressure to a low, even level during an observation time of 6 months. It is suggested that the Spitz‐Holter operation may be of benefit in cases of severe intracranial hypertension where removal of an intracranial tumour or an intracranial shunt operation does not give relief.

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