Skip to main content

Ventriculoatrial Shunt

  • Chapter
  • First Online:
Normal Pressure Hydrocephalus

Abstract

Cerebrospinal fluid (CSF) shunting is the first line of treatment for patients with hydrocephalus. The procedure diverts CSF from the ventricles to another anatomical cavity in the body like the atrium, the pleura or the peritoneum. Thus, there are several shunt placement options available. Globally, ventriculoperitoneal shunts (VPS) are the most commonly used, followed by lumboperitoneal and ventriculoatrial shunts (VAS). In this chapter, we discuss VAS, the surgical procedure, how to confirm its correct placement, its contraindications and its possible complications in contrast to other shunt placement options.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CSF:

Cerebrospinal fluid

DESH:

Disproportionately Enlarged Subarachnoid Space Hydrocephalus

VPS:

Ventriculoperitoneal Shunt

VAS:

Ventriculoatrial Shunt

IIH:

Idiopathic intracranial hypertension

NPH:

Normal pressure hydrocephalus

IJV:

Internal jugular vein

SVC:

Superior vena cava

OP:

Opening pressure

References

  1. Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH. Symptomatic occult hydrocephalus with normal cerebrospinal-fluid pressure. N Engl J Med. 1965;273(3):117–26. https://doi.org/10.1056/NEJM196507152730301.

    Article  CAS  PubMed  Google Scholar 

  2. Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure: observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. 1965;2(4):307–27. https://doi.org/10.1016/0022-510X(65)90016-X, Bakhaidar M, Wilcox JT, Sinclair.

  3. Brean A, Eide PK. Prevalence of probable idiopathic normal pressure hydrocephalus in a Norwegian population. Acta Neurol Scand. 2008;118(1):48–53. https://doi.org/10.1111/j.1600-0404.2007.00982.x.

    Article  CAS  PubMed  Google Scholar 

  4. Klassen BT, Ahlskog JE. Normal pressure hydrocephalus: how often does the diagnosis hold water? Neurology. 2011;77(12):1119–25. https://doi.org/10.1212/WNL.0b013e31822f02f5.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Vivas-Buitrago T, Gomez DF, Ramon JF, Quinones-Hinojosa A, Rigamonti D, Hakim F. Cerebrospinal fluid diversion procedures: ventriculo-atrial, ventriculo-peritoneal, ventriculo-pleural, and lumbo-peritoneal shunts. In: Schmidek and Sweet: Operative Neurosurgical Techniques: Indications, Methods and Results. Elsevier Health Sciences; 2012, pp. 993–9.

    Google Scholar 

  6. Graff-Radford NR, Jones DT. Normal pressure hydrocephalus. Continuum (Minneap Minn). 2019;25(1):165–86.

    PubMed  Google Scholar 

  7. Nulsen FE, Spitz EB. Treatment of hydrocephalus by direct shunt from ventricle to jugular vain. Surg Forum. 1951;399–403.

    Google Scholar 

  8. Sinclair DS, Diaz RJ. Ventriculoatrial Shunts: Review of Technical Aspects and Complications. World Neurosurg. 2022;158:158–64.

    Google Scholar 

  9. Mori E, Ishikawa M, Kato T, et al. Guidelines for management of idiopathic normal pressure hydrocephalus: second edition. Neurol Med Chir (Tokyo). 2012;52(11):775–809. https://doi.org/10.2176/nmc.52.775

  10. Metellus P, Hsu W, Kharkar S, Kapoor S, Scott W, Rigamonti D. Accuracy of percutaneous placement of a ventriculoatrial shunt under ultrasonography guidance: a retrospective study at a single institution. J Neurosurg. 2009;110(5):867–70.

    Article  PubMed  Google Scholar 

  11. Morone PJ, Dewan MC, Zuckerman SL, Tubbs RS, Singer RJ. Craniometrics and ventricular access: a review of Kocher’s, Kaufman’s, Paine’s, Menovksy’s, Tubbs’, Keen’s, Frazier’s, Dandy’s, and Sanchez’s points. Oper Neurosurg (Hagerstown). 2020;18(5):461–9. https://doi.org/10.1093/ons/opz194. PMID: 31420653.

    Article  PubMed  Google Scholar 

  12. Harland TA, Winston KR, Jovanovich AJ, Johnson RJ. Shunt nephritis: an increasingly unfamiliar diagnosis. World Neurosurg. 2018;111:346–8. https://doi.org/10.1016/j.wneu.2018.01.017. Epub 2018 Jan 8 PMID: 29325951.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fernando Hakim .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Usuga, V., Mattar, S.M., Gomez Amarillo, D., Ramon, J.F., Hakim, F. (2023). Ventriculoatrial Shunt. In: Bradac, O. (eds) Normal Pressure Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-031-36522-5_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-36522-5_22

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36521-8

  • Online ISBN: 978-3-031-36522-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics