Brain Disorders & Therapy

Shunts and Valves for Patients with Hydrocephalus: Benefits and Complications

Kenichi Jenjia^* Department of Neurology, Pompeu Fabra University, Barcelona, Spain
^*Correspondence: Kenichi Jenjia, Department of Neurology, Pompeu Fabra University, Barcelona, Spain, Email:

Received: 03-Jul-2023, Manuscript No. BDT-23-22503; Editor assigned: 06-Jul-2023, Pre QC No. BDT-23-22503 (PQ); Reviewed: 20-Jul-2023, QC No. BDT-23-22503; Revised: 27-Jul-2023, Manuscript No. BDT-23-22503 (R); Published: 03-Aug-2023, DOI: 10.35248/2168-975X.23.12.227

Description

The illness known as hydrocephalus is brought on by an abnormal buildup of Cerebrospinal Fluid (CSF) in the brain, which raises pressure and harms brain tissue. The clear fluid known as CSF surrounds and guards the brain and spinal cord as well as transporting nutrients and waste. Normal CSF production and absorption occur at equal rates, however in hydrocephalus, this equilibrium is upset for a variety of reasons, including congenital flaws, infections, tumours, head injuries, or bleeding.

Shunt implantation, which entails placing a device that drains the extra CSF from the brain to another part of the body where it can be absorbed, is one of the most often used therapies for hydrocephalus. A shunt typically has three parts: a valve that controls the flow and pressure of CSF, an inflow catheter that enters the brain ventricle (a cavity filled with fluid), and an outflow catheter that transports the CSF to the desired location. For patients with hydrocephalus, there are various shunted and valve types, each with a unique set of risks and advantages.

Types of Shunts

Ventriculoperitoneal shunt: The Ventriculoperitoneal (VP) shunt, which drains CSF from the brain ventricle to the abdominal cavity (peritoneum), is the most used type of shunt. The benefit of this kind of shunt is that it is simple to implant and offers a sizable area for CSF absorption. It does have certain drawbacks, though, including the potential for peritoneal infection or inflammation (peritonitis), catheter migration or occlusion, and excessive or insufficient CSF drainage.

Ventriculoatrial shunt: The Ventriculoatrial (VA) shunt is a different kind of shunt that transfers CSF from the brain ventricle to the atrium of the heart. This kind of shunt has the advantage of maintaining a consistent gradient in pressure for CSF drainage and is less likely to over drain or underdrain. However, it also has certain disadvantages, including a raised risk of infection or blood clotting in the heart or blood arteries (endocarditis or thrombosis), as well as the potential for harm to the heart valves or function.

Ventriculopleural shunt: The Ventriculopleural (VPL) shunt, which drains CSF from the brain ventricle to the chest cavity surrounding the lungs (pleura), is a less frequent type of shunt. The benefit of this kind of shunt is that it is simple to implant and offers a sizable area for CSF absorption. It does have some drawbacks, though, including the potential for pleuritis (an infection or inflammation of the pleura), the buildup of fluid in the chest cavity (a pleural effusion), or breathing difficulties brought on by increased chest pressure.

Valves

Fixed pressure valves and adjustable pressure valves are the two major types of valves used in shunts. When the pressure in the brain rises above a certain threshold that is established by the valve design, fixed pressure valves enable CSF to drain. By altering the pressure threshold using an external magnetic device, adjustable pressure valves allow for changes in the amount of CSF that passes through the valve. Both kinds of valves are also capable of incorporating a syphon control mechanism that limits excessive drainage brought on by gravity when the patient is standing. The advantage of adjustable pressure valves is that they are less susceptible to the effects of ambient magnetic fields and are more responsive to changes in the patient's condition or posture. However, they also have significant limitations, such as being more complicated and pricey, requiring routine modifications by clinician utilizing unique equipment, or being prone to breakdown or malfunction.