Toward the “Perfect” Shunt: Historical Vignette, Current Efforts, and Future Directions
Abstract
As a concept, drainage of excess fluid volume in the cranium has been around for more than 1000 years. Starting with the original decompression-trepanation of Abulcasis to modern programmable shunt systems, to other nonshunt-based treatments such as endoscopic third ventriculostomy and choroid plexus cauterization, we have come far as a field. However, there are still fundamental limitations that shunts have yet to overcome: namely posture-induced over- and underdrainage, the continual need for valve opening pressure especially in pediatric cases, and the failure to reinstall physiologic intracranial pressure dynamics. However, there are groups worldwide, in the clinic, in industry, and in academia, that are trying to ameliorate the current state of the technology within hydrocephalus treatment. This chapter aims to provide a historical overview of hydrocephalus, current challenges in shunt design, what members of the community have done and continue to do to address these challenges, and finally, a definition of the “perfect” shunt is provided and how the authors are working toward it. Show more
Publication status
publishedEditor
Book title
Advances and Technical Standards in NeurosurgeryJournal / series
Advances and Technical Standards in NeurosurgeryVolume
Pages / Article No.
Publisher
SpringerSubject
Cerebrospinal fluid; Hydrocephalus; Intracranial pressure; Neurosurgery; Physiology; Sheep model; ShuntOrganisational unit
09563 - Zeilinger, Melanie / Zeilinger, Melanie03943 - Meboldt, Mirko / Meboldt, Mirko
Funding
184913 - Quantitative study on the pathophysiology of hydrocephalus (SNF)
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ETH Bibliography
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