Management of shunt related infections

Abstract

Cerebrospinal fluid (CSF) shunts are used to reduce the increased pressure inside the brain's ventricles and divert that fluid to other body sites for absorption. The proximal portion of the shunt is usually placed in one of the cerebral ventricles, or sometimes inside a brain cyst, subarachnoidal, or lumbar spaces and the distal portion can be internalized or externalized. Internalized devices are usually placed in the peritoneal cavity (Ventriculo-peritoneal 'VP' shunt) or less likely in the heart atrium (Ventriculo-atrial 'VA' shunt) and rarely in the pleural cavity (Ventriculo-pleural shunt). Sometimes shunts can be externalized temporarily for CSF therapeutic diversion or intracranial pressure monitoring (External Ventricular Drain 'EVD') and sometimes they are externalized for administration of cancer chemotherapy into a brain tumor or administration of antibiotics (Ommaya reservoir). © 2011 Springer Science+Business Media, LLC.