have failed to reduce rates of obstruction. This failure has heightened collective awareness concerning our incomplete understanding of CSF physiology and the pathophysiology of hydrocephalus. The question of whether or not a higher level of FDA regulation and more intense focus on the CSF shunt would have resulted in a shunt with lower risk of infection and malfunction cannot be answered from this retrospective look at the problem. It is, however, an important question worthy of further exploration.


1. Bondurant CP, Jimenez DF. Epidemiology of cerebrospinal fluid shunting. Pediatr Neurosurg 1995;23(5):254–258.

2. Drake JM, Kestle JR, Tuli S. CSF shunts 50 years on—past, present and future. Child’s Nerv Syst 2000;16(10-11):800–804.

3. Brian J, Warner D. 1997. Atlas of anesthesia: Scientific principles of anesthesia. Miller R, Schwinn DA, eds.

4. Digre K. Idiopathic intracranial hypertension headache. Current Pain and Headache Reports. 6(3):217–225.

5. Aschoff A, Kremer P, Hashemi B, Kunze S. The scientific history of hydrocephalus and its treatment. Neurosurg Rev 1999;22(2-3):67–93.

6. Iantosca MR, Hader WJ, Drake JM. Results of endoscopic third ventriculostomy. Neurosurg Clin N Am 2004;15(1):67–75.

7. Engelman RM, Ransohoff J, Cortes LE, Spencer FC. Complications of ventriculoatrial shunting for hydrocephalus requiring cardiac operation. Annals of Thoracic Surgery 1969;8(5):464–469.

8. Becker DP, Nulsen FE. Control of hydrocephalus by valve-regulated venous shunt: avoidance of complications in prolonged shunt maintenance. J Neurosurg 1968 March;28(3): 215–226.

9. Muke R, Glashoff M. The longitudinal increase of the internal jugular vein and the upper v. cava as measured between the mastoid to the heart: parameter for timing the reoperation after ventriculocardiostomy (author’s transl). Monatsschr Kinderheilkd 1976 April;124(4):157–161.

10. Svien HJ, Dodge HW Jr., Lake CF. Ventriculomastoid shunt in the management of obstruction to the aqueduct of sylvius in the adult; report of case. Mayo Clinic Proceedings 1952 May;2127(11):215–218.

11. Sharkey PC. Ventriculosagittal-sinus shunt. Journal of Neurosurgery 1965 April 22;362–367.

12. Smith GW, Moretz WH, Pritchard WL. Ventriculo-biliary shunt; a new treatment for hydrocephalus. 1958:Surgical Forum 9:701–705.

13. Ransohoff J. Ventriculo-pleural anastomosis in treatment of midline obstructional neoplasms. Journal of Neurosurgery. 1954 May;11(3):295–298.

14. Jackson IJ, Snodgrass SR. Peritoneal shunts in the treatment of hydrocephalus and increased intracranial pressure: a 4-year survey of 62 patients. Journal of Neurosurgery 1955 May; 12(3):216–222.

15. Cochrane DD, Kestle JR. The influence of surgical operative experience on the duration of first ventriculoperitoneal shunt function and infection. Pediatr Neurosurg 2003 June;38(6):295–301.

16. Griebel R, Khan M, Tan L. CSF shunt complications: an analysis of contributory factors. Child’s Nerv Syst 1985;1(2):77–80.

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