UMEM Educational Pearls

Category: Neurology

Title: Cerebrospinal Fluid (CSF) Shunts

Keywords: CSF shunts, VP shunt, VA shunt, LP shunt (PubMed Search)

Posted: 7/8/2015 by WanTsu Wendy Chang, MD
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Cerebrospinal Fluid (CSF) Shunts

CSF shunts are used to manage hydrocephalus by diverting CSF from either the ventricles within the brain or the subarachnoid space around the spinal cord to another body region. (Figure 1)
Several types of CSF shunts exist; common types are:
- Ventriculoperitoneal shunt
- Ventriculoatrial shunt
- Ventriculopleural shunt
- Lumboperitoneal shunt
A CSF shunt consists of 3 parts:
- An inflow catheter directly draining CSF.
- A one-way valve mechanism regulating the amount of CSF drainage.
- An outflow catheter directing CSF to the drainage site.
There are 2 types of valve mechanisms:
- Fixed pressure valves regulate CSF drainage by a predetermined pressure threshold (i.e. low, medium, high).
- Adjustable pressure valves can be non-invasively adjusted, via specially designed magnetic tools, to set the pressure threshold.
- Some valves include a reservoir that can be used to test shunt function or to sample CSF for laboratory studies. (Figure 2)
Shunt-related complications include:
- Shunt malfunction (disconnection, migration, breaks, obstruction)
- Shunt infection / ventriculitis / meningitis
- Over-drainage
A special consideration for adjustable pressure valves is precaution around magnetic devices. If a patient is undergoing a MRI, it is recommended for the valve setting to be checked and adjusted afterwards if necessary.

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