CLINICAL QUERIES: Hydrocephalus after cerebral injury
Wendi Rank MSN, RN, CNRN, CRNP

June 2012 
Volume 42  Number 6
Pages 67 - 67
  PDF Version Available!

Why would a patient require a ventriculoperitoneal shunt after a subarachnoid hemorrhage?-G.C., HIWendi Rank, MSN, RN, CNRN, CRNP, replies: A ventriculoperitoneal shunt (VPS) drains cerebrospinal fluid (CSF) from the cerebral ventricles into the peritoneal space. The shunt is placed during a surgical procedure to treat hydrocephalus. In this condition, CSF flow is blocked, absorption of CSF is impaired, or too much CSF is produced. CSF accumulates in the brain, causing a cascade of signs and symptoms that can ultimately result in herniation and death.Under normal circumstances, more than 400 mL/day of CSF is produced and absorbed by the brain at a steady rate and 150 mL is circulating in a closed path through the four cerebral ventricles, then around the brain and spinal cord. CSF flow terminates at the arachnoid villi. These extensions of the subarachnoid space drain CSF into the cerebral venous system.1,2CSF production doesn't have a negative feedback loop or a system of checks and balances;

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