Abstract
Antisiphoning devices and gravitational valves (ShuntAssistant) have been used successfully to decrease overdrainage of CSF due to postural change, by limiting the amount of CSF outflow in the upright position. The possible advantage of a VA configuration conferred by a smaller hydrostatic column is lessened by the lack of a longer, smaller diameter distal catheter. We observed subatmospheric intracranial pressure in supine patients with ventriculoatrial shunt, associated with headaches that were worse lying down and upon awakening in the morning.
Highlights
Antisiphoning devices and gravitational valves (ShuntAssistant) have been used successfully to decrease overdrainage of CSF due to postural change, by limiting the amount of CSF outflow in the upright position
Intracranial pressure was determined by measuring CSF pressure through a lumbar spinal catheter with the fluid-coupled transducer at the level of the external auditory meatus, after zeroing to atmospheric pressure
Mean CSF pressure could be between -5 and -10 mm Hg for hours, with the amplitude of respiratory modulation of the ICP waveform as great as 15 mm Hg
Summary
Antisiphoning devices and gravitational valves (ShuntAssistant) have been used successfully to decrease overdrainage of CSF due to postural change, by limiting the amount of CSF outflow in the upright position. The possible advantage of a VA configuration conferred by a smaller hydrostatic column is lessened by the lack of a longer, smaller diameter distal catheter. We observed subatmospheric intracranial pressure in supine patients with ventriculoatrial shunt, associated with headaches that were worse lying down and upon awakening in the morning
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