Ventriculojugular shunt against the direction of blood flow. III. Operative technique and results.

One hundred hydrocephalic patients were treated over a 5-year period by shunting the cerebrospinal fluid (CSF) to the internal jugular vein (IJV) against the direction of blood flow. The patients were divided into two groups according to rigidity of their craniums. The pressures recorded during the operations confirmed the results of the experiments in Part II of this investigation. Fifteen patients had their shunting catheters removed or died due to infection (14 patients) or hemorrhage inside a brain tumor (1 patient). The shunts of 12 patients were revised due to technical faults that were corrected in 9 cases. There were no failures or complications related to the dynamics of the shunt. In the 82 patients who benefitted from the shunt, the clinical improvement was dramatic. Regression of the ventriculomegaly was inversely proportional to the degree of preoperative ventricular dilatation. In 5 infants the size of the enlarged head was reduced during surgery. Valveless shunting catheters were used in the first 4 patients, and specially designed valved catheters were used in 96 patients. The follow-up period was up to 5 years.