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D.T. Ginat et al.

 

 

6.1.10\ Lumboperitoneal Shunts

6.1.10.1\ Discussion

Lumboperitoneal shunting is an alternative method for treating pseudotumor cerebri and communicating hydrocephalus separate from ventriculoperitoneal shunting. The procedure consists of introducing an intrathecal catheter and tunneling a distal ­catheter

through the abdominal subcutaneous tissues and into the peritoneal cavity (Fig. 6.20). Lumbo­ peritoneal shunt catheters can incorporate percutaneous programmable or gravity-actuated antisiphon components, in order to regulate pressure and reduce the risk of overdrainage (Figs. 6.21 and 6.22). Reported complications include malfunction, malposition, hemorrhage, and infection.

 

Fig. 6.22  Lumboperitoneal shunt catheter with gravity-­

 

actuated horizontal-vertical (HV) valve system. Frontal

Fig. 6.20  Lumboperitoneal shunt. The patient has a his-

radiograph shows the lumboperitoneal shunt catheter in

position with gravity-actuated valve component (encir-

tory of pseudotumor cerebri and cerebrospinal fluid rhi-

cled), which is magnified in the inset

norrhea. Axial CT image shows the shunt catheter

 

(arrows) extending from the spinal canal, through the sub-

 

cutaneous tunnel, and into the peritoneum

 

Fig. 6.21  Lumboperitoneal shunt catheter with percutaneously programmable valve. Frontal radiograph shows the lumboperitoneal shunt catheter in position with a programmable valve component (encircled), which is magnified in the inset