Shunt System Case Study

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1.1 Overview

CSF definition
It is a well-known fact that the brain lies within the skull and the spinal cord lies within the vertebral column. Between the soft neutral tissues and the bones that house them are three types of membranous coverings called meninges. Some of the space between these coverings is called subarachnoid space and filled with clear and colorless fluid (cerebrospinal fluid “CSF”). CSF circulates inside the central nervous system through the ventricular part of this system and is finally absorbed into the bloodstream. Thus, the central nervous system literally floats in a cushion of CSF.1
CSF function
CSF is going under continuous circulation and as a result the central nervous system literally floats in a cushion of CSF. This cushion protects the two major areas of the central nervous system
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Currently, dominant treatment relies on passive mechanical shunts (mostly pressure controlled and limited flow controlled) which exhibit serious complications such as over drainage, under drainage, mechanical failure, infections, obstructions, and the need to lengthen or replace the catheter. These complications are not predictable and could happen after a placement of the shunt system anytime from hours to years. Shunt complication is one of the most common clinical problems in pediatric neurosurgery. Moreover, the symptoms of shunt complication are similar to the symptoms of several medical problems (e.g. headache, vomiting, and fever) so hydrocephalus patients and their families are concerned whenever the patient encounters such symptoms. The patient visits the clinic to diagnose if shunt malfunction has occurred. This process can be both difficult and perplexing even for the experienced clinician. The methods used to date have been based on clinical presentation of shunt malfunctions, clinical data, imaging techniques and evaluation of valve function in mechanical terms.4,

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