Cerebrospinal fluid flow through an implanted shunt.

Abstract

Although the circulation of cerebrospinal fluid enjoys an apparent simplicity, its underlying basis is amazingly complex. Many factors influence how CSF flows through the human central nervous system. In the presence of hydrocephalus and subsequent shunt placement, this system is further complicated. The challenge before us then is to advance our understanding of the mechanisms that underlie CSF circulation, to place within that context the implications of shunt dependency, and to design a shunt system capable of simultaneous redirection of CSF and restoration of the CNS toward normal. Such a new shunt system would have to overcome not only those complications that result from hydrocephalus, but also those that result from the shunt's very placement. The purpose of this publication is 1. to provide an overview of the CSF circulatory system in the context of hydrocephalus and shunt dependency; 2. to explore resultant complications within the framework of those factors that influence CSF circulation within the human biological system as well as those that arise from the factors that influence CSF flow through a shunt; and 3. to propose in brief an alternative shunt valve designed to restore the accumulator function of the CNS toward normal.