title: Ventricular-subcutaneous shunt for the treatment of experimental hydrocephalus in young rats: technical note.
abstract: BACKGROUND
  Hydrocephalus is a complex disease that affects cerebrospinal fluid (CSF) dynamics and is very common in children. To this date, CSF shunting is still the standard treatment for childhood hydrocephalus, but, nevertheless, the effects of such an operation on the developing brain are widely unknown. To help overcome this, experimental models of CSF shunts are surely very useful tools.
  
  
  OBJECTIVE
  The objective of this study was to describe a feasible and reliable technique of an adapted ventricular-subcutaneous shunt for the treatment of kaolin-induced hydrocephalus in young rats.
  
  
  METHODS
  We developed a ventricular-subcutaneous shunt (VSCS) technique which was used in 31 Wistar young rats with kaolin-induced hydrocephalus. Hydrocephalus was induced at 7 days of age, and shunt implantation was performed 7 days later. Our technique used a 0.7-mm gauge polypropylene catheter tunneled to a subcutaneous pocket created over the animal's back and inserted into the right lateral ventricle. All animals were sacrificed 14 days after shunt insertion.
  
  
  RESULTS
  Twenty-four rats survived and remained well until the study was ended. No major complications were seen. Their weight gain went back to normal. They all underwent ambulatory behavioral testing prior and after VSCS, which showed improvement in their motor skills. We have also obtained magnetic resonance (MR) scans of 16 pups confirming reduction of ventricular size after shunting and indicating effective treatment. Histopathological analysis of brain samples before and after shunting showed reversion of ependymal and corpus callosum disruption, as well as fewer reactive astrocytes in shunted animals.
  
  
  CONCLUSIONS
  An experimental CSF shunt technique was devised. Excessive CSF of hydrocephalic rats is diverted into the subcutaneous space where it can be resorbed. This technique has a low complication rate and is effective. It might be applied to various types of experimental studies involving induction and treatment of hydrocephalus.
authors.affiliation: Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus Universitário, Ribeirão Preto, SP, 14049-900, Brazil. marcelovolpon@yahoo.com.|Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. marcelovolpon@yahoo.com.
authors.forename: Marcelo Volpon
authors.identifier: http://orcid.org/0000-0002-0850-7039
authors.initials: MV
authors.lastname: Santos
authors.affiliation: Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Camila Araujo Bernardino
authors.initials: CA
authors.lastname: Garcia
authors.affiliation: Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Evelise Oliveira
authors.initials: EO
authors.lastname: Jardini
authors.affiliation: Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Thais Helena
authors.initials: TH
authors.lastname: Romeiro
authors.affiliation: Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Luiza
authors.initials: L
authors.lastname: da Silva Lopes
authors.affiliation: Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus Universitário, Ribeirão Preto, SP, 14049-900, Brazil.|Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Hélio Rubens
authors.initials: HR
authors.lastname: Machado
authors.affiliation: Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Campus Universitário, Ribeirão Preto, SP, 14049-900, Brazil.|Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Ricardo Santos
authors.initials: RS
authors.lastname: de Oliveira
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D000930:Antidiarrheals / Q000633:toxicity; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D057785:Catheters; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D004195:Disease Models, Animal; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006849:Hydrocephalus / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000601:surgery*; D055104:Infusions, Subcutaneous; D007616:Kaolin / Q000633:toxicity; D008279:Magnetic Resonance Imaging; D051381:Rats; D017208:Rats, Wistar
chemical_list: D000930:Antidiarrheals; D005904:Glial Fibrillary Acidic Protein; D007616:Kaolin
keywords: CSF shunting; Cerebrospinal fluid; Experimental hydrocephalus; Kaolin-induced hydrocephalus