title: Lumbar subcutaneous shunt: a novel technique for therapeutic decision making in normal pressure hydrocephalus (NPH) and benign intracranial hypertension (BIH).
abstract: Selecting patients who will benefit from a permanent CSF diversion procedure in benign intracranial hypertension (BIH) or communicating hydrocephalus due to normal pressure hydrocephalus (NPH) has inherent problems. The percutaneous introduction of a lumbar subcutaneous shunt (LSS) under local anaesthesia facilitates both a prolonged CSF drainage under aseptic conditions and also elicits an adequate clinical response. We describe the technique of a lumbar subcutaneous shunt and our experience with its use in patients with BIH and NPH. Postprocedure changes in the patients' clinical status were noted. Patients with a transient clinical improvement underwent a subsequent definitive CSF diversion; those with a sustained clinical improvement or no change in symptoms had no further procedure.
authors.affiliation: Department of Neurosurgery, Newcastle General Hospital, Regional Neurosciences Centre, Newcastle-upon-Tyne, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ushewokunze
authors.forename: H N
authors.initials: HN
authors.lastname: Haja Mydin
authors.forename: R
authors.initials: R
authors.lastname: Prasad
authors.forename: A D
authors.initials: AD
authors.lastname: Mendelow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011559:Pseudotumor Cerebri / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult