The ventriculocaval shunt in the treatment of adult hydrocephalus

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Abstract
✓ The authors report their experience with ventriculocaval shunts in 101 adult patients with hydrocephalus, raised intracranial pressure, or disturbed cerebrospinal fluid dynamics. Following the insertion of a Holter or Pudenz ventriculocaval shunt, 43 patients developed 71 complications. The commonest of these was blockage of the ventricular catheter which was four times more likely to occur if the perforated end of the catheter was placed elsewhere than in the frontal horn of the ipsilateral lateral ventricle. Of the 71 complications, 45 occurred within 3 months of the initial insertion, and only six patients out of 66 surviving at that time developed complications later than 1 year after the initial insertion. The variable relationship of the cavoatrial junction to the skeleton in adult patients is described, and the importance of accurate placement of the ventricular and caval ends of the system emphasized.