Hydrogel Ventriculo-Subdural Shunt for the Treatment of Hydrocephalus in Children

We designed a hydrogel ventriculo-subdural shunt and implanted it in eight infants with nontumoral hydrocephalus. Through this shunting procedure, cerebral spinal fluid (CSF) was drained to the subdural space over the cerebral hemisphere and was absorbed there. Computerized tomography (CT) brain scan studies were performed pre- and post-operatively to evaluate the function of the shunt and the change of intracranial CSF spaces after shunt insertion. Most of the infants demonstrated gradual relief of intracranial pressure with diminished head circumference and ventricular size. Postoperative CT scan studies showed no subdural fluid collection in one infant, unilateral subdural CSF collection in four infants, and bilateral subdural CSF collection in two infants. Three infants required no further shunt operation. Four infants required additional extracranial shunt insertions because of disturbance of CSF absorption in the subdural lining. One patient died suddenly at home, during sleep, two months after the ventricular subdural shunt insertion, without evidence of acute or chronic increase of intracranial pressure.