Treatment of hydrocephalus with functionally isolated ventricles

Summary

Rapid therapeutic drainage of one lateral ventricle may lead to ipsilateral slit ventricle, and the resultant functional obstruction of cerebrospinal fluid flow through the foramen of Monro may cause dilatation of the contralateral ventricle. Drainage of the lateral ventricle with a low-pressure shunt led to functionally isolated contralateral ventriculomegaly in this report. The patient’s condition was complicated by a Candida albicans shunt infection. Following effective treatment of the infection by chemotherapy and removal of the shunt system, the patient was treated by bridging two lateral ventricles with ventricular catheters connected to an Ommaya reservoir. An occipital ventricular catheter was then inserted and connected to a programmable valve to drain the bridged lateral ventricles. Modern centers, caring for patients with infantile hydrocephalus, should have endoscopic facilities available but in cases with extensive ventricular adhesions and in asymmetric hydrocephalus where endoscopic septostomy between the ventricles is impossible our described technique may be used.