J Neurointensive Care.  2021 Oct;4(2):68-72. 10.32587/jnic.2021.00374.

Negative-Pressure Hydrocephalus Treated with a Modified Shunt System: A Case Report

• Park HS
• Lee SH
• Park CK
• Ha EJ

• KMID: 2555054
• DOI: http://doi.org/10.32587/jnic.2021.00374

Abstract

A negative-pressure hydrocephalus (NePH) is a rare type of hydrocephalus that is symptomatic despite the negative intracranial pressure (ICP). Because of the shortcomings of the existing shunt system that could not produce the necessary gradient for an effective cerebrospinal fluid (CSF) drainage in NePH patients, a refined method for CSF drainage is needed. We combined the traditional low-pressure valve with a distal catheter, which has no end hole and only has side slits, to prevent the CSF backflow and facilitate the siphon effect. Simultaneously, the active pumping of the shunt reservoir was also conducted to remove the excess CSF from the ventricular system. The treatment of NePH requires an appropriate reduction of excessive CSF until the CSF dynamics and brain compliance are restored. We suggest the use of this modified shunt system for NePH treatment, as it is easily modifiable and has sufficient effects.

Keyword

Hydrocephalus; Low pressure; Negative pressure; Shunt