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Child's Nervous System

, Volume 35, Issue 9, pp 1561–1564 | Cite as

Ventriculo-humeral shunt: a cadaveric feasibility study with application to treating hydrocephalus

  • Mohammad W. Kassem
  • Basem Ishak
  • Karishma Mehta
  • Joe Iwanaga
  • Marios Loukas
  • R. Shane TubbsEmail author
Original Article

Abstract

Purpose

Intraosseous vascular access is often used when vascular access is difficult. However, the use of this space for a receptacle for cerebrospinal fluid (CSF) diversion has been scantly considered.

Materials and methods

Six upper limbs of fresh frozen cadavers were used for this study. In the supine position, a small hole was drilled through the outer cortex of the proximal humerus and into the medullary cavity. A 16-gauge needle was placed into the hole in the humerus and 150 cc of saline infused. Next, the adjacent axillary vein and tributaries were dissected to observe dilation or the presence of the blue-colored saline. For part two of the study, shunt tubing was passed subcutaneously from a supraclavicular incision to the hole made in the humerus. Range of motion of the shoulder was then performed.

Results

On all sides, all 150 cc of fluid was easily infused into the humerus. No specimen was found to have leakage from the drill hole site or into the extravascular soft tissues. With dissection of the axillary vein and its tributaries, all sides were found to have engorgement of these vessels. No tension was placed on the distal shunt tubing with full range of motion of the shoulder.

Conclusion

Based on our study, the humerus is another option available to the neurosurgeon for CSF diversion.

Keywords

Ventricular shunts Humerus Hydrocephalus Intraosseous 

Notes

Compliance with ethical standards

As a cadaveric study, our institution does not require IRB approval. However, ethical considerations were in accord with the Declaration of Helsinki.

Conflict of interest

The authors have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Mohammad W. Kassem
    • 1
    • 2
    • 3
  • Basem Ishak
    • 1
  • Karishma Mehta
    • 2
  • Joe Iwanaga
    • 1
  • Marios Loukas
    • 2
  • R. Shane Tubbs
    • 1
    • 2
    Email author
  1. 1.Seattle Science FoundationSeattleUSA
  2. 2.Department of Anatomical SciencesSt. George’s UniversityTrue BlueGrenada
  3. 3.Mercy Health Neuroscience InstituteToledoUSA

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