engleski

Sinus Shunt: The ultimate site of shunting in hydrocephalus

Objective Actual ventriculo-peritoneal and ventriculo-atrial shunts are burdened with unacceptably high rate of complications. The mean « shunt survival» is 50% or less at five years and the rate of reoperation 2.7 per shunt. The mechanical complications are caused by an inadequate technology and by « unphysiological» drainage of CSF in the above mentioned sites. The are two good reasons for changing the present standard of shunting to a new method that employs cerebral venous sinuses. Firstly, the normal receiving site of CSF are dural venous sinuses, and secondly, shunting to transverse sinus menas far less mechanical and catether-related comlications. Material and methods From February 2002 we started to implant in hydrocehalic patients a new shunting device called Sinu-Shunt (CSF Dynamics – Denmark) who drain the CSF from lateral ventricle to the transverse sinus. It is a one-way valve with an in-built resistance to flow equal to the normal value for CSF outflow which imitate the physiological liquor dynamics. Three hydrocehalic patients (one child and two adolescents, mean age 15.3 years) were operated on and shunting in the transverse sinus was performed. All patients had chronic hydrocephalus (dysraphic, haemorrhagic and uncertain etiology) and two of them had history of previous surgeries with standard technique and technology. Results Sinu-Shunt implantations proceeded uneventfully and there were no complications in the follow-up (mean 24.3 months). Functional MRI studies showed patency of the shunt and transverse sinus. Conclusion Surgical shunting procedure has proved to be simple, fast and safe. No major problems were encountered in the localization and opening of the transverse sinus, and no adverse effects were recorded during the observation period. Although our preliminary results are promising, additional studies are needed to test the validity and efficacy of the sinus shunt.

Sinus shunt; hydrocephalus

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