Surgical Treatment of Hydrocephalus Based on CSF Shunt Devices

Living reference work entry


The history of the treatment of hydrocephalus by shunting devices starts in the years across the nineteenth and twentieth century with the first attempts to temporarily drain outside the CSF, to bypass any obstruction along the CSF pathway with ventriculo-subarachnoid shunts, and to shunt CSF into extrathecal compartments. Although the results of these procedures were encouraging, they were burdened by an unacceptably high mortality rate.

These pioneristic experiences were soon supported by the technological progress, and the year 1949 can be seen as the beginning of the modern era of shunting, thanks to the implantation of the first functional hydrocephalus valve and the introduction of silicone as human prosthesis. Decisive improvements came soon after with the construction of the four classical mechanisms of differential pressure valve and the refinement and standardization of surgical techniques, with a shift from the venous system to the peritoneal cavity as the ideal receiving site for CSF. Nowadays, ventriculo-peritoneal shunt is the most common shunting technique for treating hydrocephalus, and ventriculo-atrial shunt remains the second choice, reserved to cases of peritoneal cavity not suitable to resorb CSF. Lumboperitoneal and more rarely ventriculo-pleural shunts have selective indications.


CSF shunting Hydrocephalus Spino-peritoneal shunt Ventriculo-atrial shunt Ventriculo-peritoneal shunt Ventriculostomy 


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Authors and Affiliations

  1. 1.Pediatric NeurosurgeryFondazione Policlinico Universitario A. Gemelli, Catholic University Medical SchoolRomeItaly
  2. 2.Pediatric NeurosurgeryInternational Neuroscience InstituteHannoverGermany

Section editors and affiliations

  • Concezio Di Rocco
    • 1
  • Gianpiero Tamburrini
    • 2
  1. 1.International Neuroscience InstituteHannoverGermany
  2. 2.Pediatric NeurosurgeryFondazione Policlinico Universitario A. Gemelli, Catholic University Medical SchoolRomeItaly

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