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The Solved and Unsolved Problems of Hydrocephalus Valves: A Critical Comment

  • Conference paper
Intracerebral Hemorrhage Hydrocephalus malresorptivus Peripheral Nerves

Part of the book series: Advances in Neurosurgery ((NEURO,volume 21))

Abstract

Four goals should be aimed at with an artificial shunt: (1) The intraventricular pressure must be kept within physiological ranges, especially during intracranial pressure (ICP) crises, independent of the body position, coughing, crying of children, external pressure, and flexion and torsion of valve or shunt components. (2) In venous shunting, reflux must be strictly excluded. For peritoneal shunting this aim seems less obligatory. (3) Ideally, a shunt system should offer the possibility of reestablishing shunt independency step by step, or a very close approximation to this. (4) Design, material, and surface of a life-long implant should produce optimum biocompatibility, stability, and durability: In 25 years, a valve must potentially resist a billion opening and closing maneuvers, caused by cardiac actions and breathing. When a valve is pumped, pressure peaks of up to 2000 mmHg, a maximum flow of 2000 ml/h, and a suction before the valve of −330 mmHg occur. Shunts are surrounded by a chemically aggressive milieu and threatened by protein, calcium precipitations, and detritus around the clock.

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Author information

Authors and Affiliations

  1. Neurochirurgische Klinik, Universität Heidelberg, Im Neuenheimer Feld 400, W-6900, Heidelberg, Germany

    A. Aschoff, C. Benesch, P. Kremer, M. S. von Haken, A. Klank, M. Osterloh & K. Fruh

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  1. A. Aschoff
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  2. C. Benesch
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  3. P. Kremer
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  4. M. S. von Haken
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  5. A. Klank
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  6. M. Osterloh
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  7. K. Fruh
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Editors and Affiliations

  1. Neurochirurgische Universitätsklinik, Schleusenweg 2-16, W-6000, Frankfurt/M, Germany

    Rüdiger Lorenz

  2. Neurochirurgische Klinik, Universitätsklinik Erlangen-Nürnberg, Schwabachanlage 6, (Kopfklinikum), W-8520, Erlangen, Germany

    Margareta Klinger

  3. Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Steglitz, Freie Universität Berlin, Hindenburgdamm 30, W-1000, Berlin 45, Germany

    Mario Brock

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© 1993 Springer-Verlag Berlin Heidelberg

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Aschoff, A. et al. (1993). The Solved and Unsolved Problems of Hydrocephalus Valves: A Critical Comment. In: Lorenz, R., Klinger, M., Brock, M. (eds) Intracerebral Hemorrhage Hydrocephalus malresorptivus Peripheral Nerves. Advances in Neurosurgery, vol 21. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77997-8_19

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  • DOI: https://doi.org/10.1007/978-3-642-77997-8_19

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