About Bioline  All Journals  Testimonials  Membership  News

Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886 EISSN: 1998-4022
Vol. 58, Num. 2, 2010, pp. 179-184

Neurology India, Vol. 58, No. 2, March-April, 2010, pp. 179-184

Review Article

Lumbar peritoneal shunt

Neurosurgery Unit, NSCB Medical College, Jabalpur, Madhya Pradesh, India

Correspondence Address: Yad R Yadav, 105, Nehru Nagar, Opposite Medical College, Jabalpur, Madhya Pradesh, India,

Code Number: ni10052

PMID: 20508332

DOI: 10.4103/0028-3886.63778


A lumbar peritoneal (LP) shunt is a technique of cerebrospinal fluid (CSF) diversion from the lumbar thecal sac to the peritoneal cavity. It is indicated under a large number of conditions such as communicating hydrocephalus, idiopathic intracranial hypertension, normal pressure hydrocephalus, spinal and cranial CSF leaks, pseudomeningoceles, slit ventricle syndrome, growing skull fractures which are difficult to treat by conventional methods (when dural defect extends deep in the cranial base or across venous sinuses and in recurrent cases after conventional surgery), raised intracranial pressure following chronic meningitis, persistent bulging of craniotomy site after operations for intracranial tumors or head trauma, syringomyelia and failed endoscopic third ventriculostomy with a patent stoma. In spite of the large number of indications of this shunt and being reasonably good, safe, and effective, very few reports about the LP shunt exist in the literature. This procedure did not get its due importance due to some initial negative reports. This review article is based on search on Google and PubMed. This article is aimed to review indications, complications, results, and comparison of the LP shunt with the commonly practiced ventriculoperitoneal (VP) shunt. Shunt blocks, infections, CSF leaks, overdrainage and acquired Chiari malformation (ACM) are some of the complications of the LP shunt. Early diagnosis of overdrainage complications and ACM as well as timely appropriate treatment especially by programmable shunts could decrease morbidity. Majority of recent reports suggest that a LP shunt is a better alternative to the VP shunt in communicating hydrocephalus. It has an advantage over the VP shunt of being completely extracranial and can be used under conditions other than hydrocephalus when the ventricles are normal sized or chinked. More publications are required to establish its usefulness in the treatment of wide variety of indications.

Keywords: Cerebrospinal fluid shunt, hydrocephalus, lumbar peritoneal shunt, ventriculoperitoneal shunt


Communicating hydrocephalus secondary to an infective cause is quite common in countries like India while it is more frequent following subarachnoid hemorrhage (SAH) in western countries. Shunt surgery has been found to be effective in such hydrocephalus. A lumbar peritoneal (LP) shunt has an advantage of being an entirely extracranial operation. It is a very effective and safe method of treatment in communicating hydrocephalus compared to the ventriculoperitoneal (VP) shunt. [1],[2],[3] A LP shunt is also effective under some nonhydrocephalus conditions. Initial reports of very high complications have put this procedure into disrepute [4],[5] which has led to underutilization of this procedure. In spite of its use in a wide variety of indications only few reports about LP shunts exist in the literature. We are therefore reviewing the indications, results, and complications of this procedure.


A LP shunt is indicated under a large number of conditions as shown in [Table 1]. It is contraindicated in obstructive hydrocephalus.

Communicating hydrocephalus

A LP shunt has been found to be quite effective and comparatively safe in communicating hydrocephalus. [1],[2] Communicating hydrocephalus is quite common in tubercular meningitis (TBM), other chronic infections, postpyogenic meningitis, and SAH. It is also seen following trauma and surgery.

Idiopathic intracranial hypertension

Idiopathic intracranial hypertension (IIH) is a condition that usually affects young, obese women. Management is aimed at controlling symptoms of increased intracranial pressure (ICP) and prevention of visual failure due to papilledema. A common surgical treatment for IIH is the insertion of a LP shunt. It is a very effective procedure to treat this condition when conservative treatment fails and the vision is threatened. [1],[6],[7],[8],[9],[10],[11]

Normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is considered to be a treatable form of dementia. A LP shunt has been found to be effective in NPH. [12],[13]

Spinal cerebrospinal fluid leaks

Cerebrospinal fluid (CSF) leak can occur following spinal surgery or penetrating trauma. Such fistulas are sometimes refractory to direct repair, external drainage, and blood patches. A LP shunt is effective in these difficult situations. [1],[14]

Cranial base cerebrospinal fluid leaks

A LP shunt could be used in CSF rhinorrhea following either cranial injury, skull base surgery or of unknown etiology. This is one of the techniques to manage such patients when direct closure of fistula fails. This is also indicated in CSF rhinorrhea with raised intracranial pressure. [1],[11],[15]


Pseudomeningoceles can occur after spinal and posterior cranial fossa surgery. A LP shunt is an effective treatment under these conditions. [1],[11],[14]

Slit ventricle syndrome

Slit ventricle syndrome (SVS) has been described in hydrocephalus patients who continue to have shunt malfunction-like symptoms in the presence of a functioning shunt system and small ventricles on imaging studies. A LP shunt is indicated in a subset of patients with SVS who are symptomatic with high ICP. It is postulated that this subgroup of patients previously treated with VP shunting behave in a fashion similar to pseudotumor cerebri patients and such patients respond well to a LP shunt. [16],[17],[18]

Growing skull fracture

A LP shunt is indicated in growing skull fractures which are difficult to treat by conventional methods such as when the dural defect extends deep in the cranial base or across venous sinuses and in recurrent cases after conventional surgery. It should be done when bulging disappears after the lumber puncture. [1],[19] Yadav et al. reported a good outcome after a LP shunt under this condition. Its counterpart, a VP shunt, has also been used for the treatment of craniocerebral erosion (growing skull fracture) in difficult cases and recurrent cases after conventional surgery [20],[21] but the VP shunt procedure is difficult when ventricles are not dilated.

Raised intracranial pressure following chronic meningitis

Elevated ICP in patients with meningitis is a significant source of morbidity and mortality. Use of early LP and VP shunts in the management of elevated ICP can ameliorate the sequelae of elevated ICP. [22],[23]

Failed endoscopic third ventriculostomy with a patent stoma

Hydrocephalus can be classified as purely obstructive, purely communicating, or due to combinations of pathologies (obstruction in addition to defective absorption). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus. However, patients who have combination of pathologies (complex hydrocephalus) could result in the failure of ETV in spite of a patent stoma due to defective CSF absorption or impaired CSF permeation through subarachnoid space. A LP shunt is effective in the treatment of such patients. [24]

Persistent bulging of the craniotomy site after intracranial tumors or head trauma operations

A LP shunt is quite effective in patients with bulging craniotomy without ventriculomegaly. Such patients could have features of raised ICP. [11] These patients usually do not have dilated ventricles where a VP shunt is very difficult.


Although a valveless LP shunt may expose patient to the risk of symptomatic ACM and syringomyelia, a LP shunt with an adjustable pressure valve could successfully manage such complications. [25] Bret et al.[11] and Vassilouthis et al. [26] performed a LP shunt successfully for the primary treatment of syringomyelia associated with progressive myelopathy. Park et al. suggested that CSF moves under pressure into the spinal cord, contributing to the formation and maintenance of the syrinx. They found that the LP shunting combined with myelotomy could result in the shrinkage of the syrinx. [27]


The introduction of a LP shunting system may be accomplished through a variety of surgical techniques. A surgeon is best advised to use the method which is best suited to his/her own practice and training. A shunt could be in a single-piece system or a two- or three-piece system. Here we are describing the technique of a two-piece system (lumbar and peritoneal end). A 0.5-1 cm skin incision is given between the spinous process of L4-5 or L5-S1. We usually give a 1-2 cm paraspinal incision which prevents incision dehiscence due to pressure especially in malnourished and unconscious patients. A Tuohy needle can be inserted in the midline after the paraspinal incision. The head end of the table is temporarily elevated 30° to increase the pressure in the lumbar subarachnoid space. A fourteen-gauge Tuohy needle is inserted into the lumbar subarachnoid space with the bevel-pointed cephalad. The lumbar end of the catheter is passed through the Tuohy needle. The operating table is tilted back to the normal position. The needle is withdrawn over the catheter. The extra length of the catheter is cut. A single suture collar is placed around the catheter in the lumbar area and sutured to the subcutaneous tissue to hold the catheter in place. A small incision is made in the flank and the subcutaneous catheter passer with the obturator in place is passed through the flank incision. The obturator is removed and the distal end of the peritoneal catheter is inserted into the lumbar opening of the subcutaneous catheter passer. The subcutaneous catheter passer is withdrawn over the catheter leaving the flank portion in place. A small skin incision is made 2 cm below the umbilicus and 3 cm away from the midline. The subcutaneous catheter passer with the obturator in place is inserted from the abdominal incision to the flank incision. The obturator is removed and the peritoneal end is inserted into the flank opening of the catheter passer. The catheter is passed through the passer. The shunt can be inserted into the peritoneal cavity using a peritoneal trocar. An Allis clamp on the aponeurosis is secured and firm outward traction on the abdominal wall is applied. The trocar is inserted through a small stab incision in the superficial layer of the aponeurosis into the peritoneal cavity, while continued outward traction is applied on the Allis clamp. The trocar is removed after insertion. The catheter can also be inserted into the peritoneal cavity under direct vision. A suture collar is placed around the catheter tubing. The collar is sutured to the subcutaneous tissues. All incisions are closed in the usual manner.

The thecal end of the shunt is smaller in diameter as compared to the peritoneal end. The Chhabra LP shunt comes with a Tuohy needle. It has a lumbar end which is radiopaque which has an outer diameter of 1.5 mm and an inner diameter of 0.7 mm. The proximal end of the lumbar end bears multiple holes and it is marked at 5, 10, and 15 cm distance from the proximal perforated tip. The lumbar end can pass through the 14-gauge Tuohy needle. The peritoneal end is also radiopaque with a 2.5 mm outer diameter and a 1.3 mm inner diameter. The peritoneal end catheter tip has two pairs of slit valve. Other shunt systems such as Spetzler, Codman, Medtronics, Aesculap, etc. are also available commercially. Programmable/adjustable valves are also commercially available such as Codman Hakim, Medtronics, Aesculap, Phoenix, Integra, etc. Use of a programmable shunt can significantly increase the probability of shunt implantation being a one-time procedure. If the pressure setting of a fixed pressure shunt proves to be a mismatch after surgery, causing underdrainage or overdrainage complications, the patient must undergo a complete or partial shunt revision, sometimes more than once. This is a limitation of all fixed pressure shunts.

The opening pressure of programmable shunts can be changed via an external magnet so that surgery is not necessary for a pressure change. The one downside of a programmable shunt is that large magnetic fields can change the pressure setting. As a result, if an MRI is needed the shunt will need to be reprogrammed immediately following the MRI. This does not mean that an MRI cannot be done; it just means that the shunt needs to be reprogrammed.

LP shunt placement requires access to the lumbar theca in the lateral position and peritoneal end in the supine position. This position change could be bothersome, especially in heavy patients. Shimizu et al. developed a transportation board to facilitate changing the patient position while keeping the surgical drapes in place. [28] To avoid this change in position, some authors have placed the peritoneal end in the lateral position using a laparoscopy-assisted technique. [29],[30] Goitein et al. described single-trocar laparoscopy-assisted placement of peritoneal shunts. [31] The direct placement of a peritoneal catheter from back by the laparoscopy-assisted technique was described by Johna et al. [3] Kubo et al. developed a method for the retroperitoneal placement of a LP shunt with the aid of endoscopic monitoring. [32]

Assessment of the Functioning Shunt

The placement of the LP shunt tube and the evaluation of its patency can be done using a laparoscopy-assisted technique. [33,34] The intrathecal administration of In-111 DTPA (diethylene-triamine-penta-acetic acid) and sequential images of the abdomen and of the head can be used to assess shunt patency. [12]

LP shunt patency can be assessed by LP shuntography in which patency of the shunt can be judged by the intraperitoneal spread of the contrast medium injected intrathecally via the lumbar route. [35],[36] A thermosensitive determination technique is another method in which patency of the shunt can be assessed by definite temperature changes. [37]

Postoperative Imaging after LP Shunting

A decrease in the size of the ventricles occurs very slowly in about few weeks to months after a successful shunt. Patients with chronic dilatation of ventricles take longer time and in some cases the ventricles do not become normal. The clinical status along with the comparison of pre- and postoperative imaging is more important than the ventricle size alone in a single imaging. Failure to decrease in size of ventricles or increase in size with clinical deterioration or failure to improve is suggestive of shunt malfunction.

Comparison of LP Shunt Results with a VP Shunt

A LP has an advantage of being a completely extracranial procedure. It is better in growing children as fewer revisions are required as compared to the VP shunt due to comparative shortening of the shunt tube because of patient′s growth. Aoki reviewed 207 cases of LP shunt and 120 comparable cases of VP shunt and found that the incidence of infection and malfunction with a LP shunt is significantly lower than that with a VP shunt. They also observed that the LP shunt is also indicated for pediatric patients, although a relatively higher incidence of malfunction was noted compared to the adults. [2] They reported a very low incidence of ACM after the LP shunt.

Wang et al. reported that the placement of LP shunts with a horizontal-vertical valve for the treatment of communicating hydrocephalus seems to be a safe procedure. Serious overdrainage complications such as subdural hematoma (SDH) were not observed with the valve system. The horizontal-vertical valve was associated with minor complications but it was effective in reducing the incidence of overdrainage complications. [38] Rekate also found that LP shunts may be used for specific indications without excessive risk of hindbrain herniation. [39] Yadav et al. found a low incidence of shunt block in the LP shunt as compared to the VP shunt; they also observed a very low incidence of ACM (0.5%). On the other hand, Kim et al. observed that a VP shunt is the better choice compared to LP shunts in treating chronic hydrocephalus after aneurismal SAH. [40]


Shunt block, infections, and CSF leak are quite common in LP shunts. [1],[2] Sudden visual loss can occur due to an acute rise in ICP because of shunt block. [41]

The incidence of ACM was very high in Chumas et al.[4] and Payner et al. [5] series while it was very low (0.5%) in Yadav et al.[1] and Aoki et al. (1%) series. [2] Rekate et al. [39] did not come across any risk of ACM in children; they used the valve system in majority (84%) of patients. Lam et al. also found secondary ACM rarely after the LP shunt. [42] Riffaud et al. observed that the valveless LP shunt may expose the patient to the risk of symptomatic ACM and syringomyelia. They suggested a LP shunt with an adjustable valve to prevent such complications. [25] It is evident from these reports that the overdrainage complications such as ACM can be avoided by a programmable shunt.

Liao et al. described intracranial hypotension from the leakage of CSF through a defect in the lumbar dura created by the shunt catheter in a LP shunt. [43] Tension pneumocephalus may develop following continuous lumbar drainage [44] but such complication has not been described in a LP shunt procedure. Acute SDH is a rare complication of LP shunts. [45] These complications can be prevented by an adjustable valve.

Shunt migration after LP shunt procedures can occur upward into the spinal subarachnoid space and downward into the abdominal cavity. Cranial migrations are less common than downward migration into the abdominal cavity. Defects of the fixation devices in the shunt system are considered the main cause. Raised abdominal pressure and a strong force produced by lumbar movements are supposed to be related to upward migration. [46],[47] A rare complication of cranial migration of the catheter in the posterior fossa has been reported. [48] There were reports of back pain with or without sciatica, hamstring tightness, foot deformities, lumbar hyperlordosis, lordoscoliosis, and scoliosis in old shunt systems. These deformities are postulated to be the result of arachnoiditis involving the conus medullaris and lower lumbar roots. [49] Subarachnoid hemorrhage and intracereebral hematoma have been reported following a LP shunt. [50]

Shunt infection varies from 1% to 9% in various series. [1],[2],[18],[38],[51] The incidence of shunt revision ranges from 11% to 50% in various series. [1],[2],[38] Overdrainage complications were recorded in 1-15% patients. [2],[38],[51] It was seen in 15% patients in the LP shunt group without a valve while the LP shunt with a valve did not develop any overdrainage complications. [38] Overdrainage complications can be avoided by a programmable valve. [25],[38],[39],[52] Shunt blocks were seen in 4-14% cases. [1],[2],[51]


1.Yadav YR, Pande S, Raina VK, Singh M. Lumboperitoneal shunts: Review of 409 cases. Neurol India 2004;52:188-90.  Back to cited text no. 1  [PUBMED]  Medknow Journal
2.Aoki N. Lumboperitoneal shunt: Clinical applications, complications, and comparison with ventriculoperitoneal shunt. Neurosurgery 1990;26:998-1003;discussion 1003-4.  Back to cited text no. 2  [PUBMED]  
3.Johna S, Kirsch W, Robles A. Laparoscopic-assisted lumboperitoneal shunt: A simplified technique. J Soc Laparoendoscp Surg 2001;5:305-7.  Back to cited text no. 3    
4.Chumas PD, Armstrong DC, Drake JM. Tonsillar herniation: The rule rather than the exception after Lumboperitoneal shunting in pediatric population. J Neurosurg 1993;78:568-73.   Back to cited text no. 4    
5.Payner TD, Prenger E, Berger TS, Crone KR. Acquired Chiari malformations: Incidence, Diagnosis and management. Neurosurgery 1994;34:429-34.   Back to cited text no. 5  [PUBMED]  [FULLTEXT]
6.Kesler A, Gadoth N. Pseudotumor cerebri (PTC--an update). Harefuah 2002;141:297-300, 312.  Back to cited text no. 6  [PUBMED]  
7.Aboul Enein HA, Abo Khair AF. Idiopathic intracranial hypertension in children: Clinical presentations and management. Middle East Afr J Ophthalmol 2008;15:113-6.   Back to cited text no. 7    
8.Corbett JJ, Thompson HS. The rational management of idiopathic intracranial hypertension. Arch Neurol 1989;46:1049-51.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Feldon SE. Visual outcomes comparing surgical techniques for management of severe idiopathic intracranial hypertension. Neurosurg Focus 2007;23:E6.  Back to cited text no. 9    
10.Burgett RA, Purvin VA, Kawasaki A. Lumboperitoneal shunting for pseudotumor cerebri. Neurology 1997;49:734-9.  Back to cited text no. 10  [PUBMED]  
11.Bret PH, Huppert J, Massini B, Lapras C, Fischer G. Lumbo-peritoneal shunt in non-hydrocephalic patients: A review of 41 cases. Acta Neurochir 1986;80:90-2.  Back to cited text no. 11    
12.Ashraf R, Sostre S. Differing scintigraphic patterns of lumboperitoneal shunt dysfunction in patients with normal pressure hydrocephalus and pseudotumor cerebri. Clin Nucl Med 1995;20:140-6.  Back to cited text no. 12  [PUBMED]  
13.Philippon J, Duplessis E, Dorwling-Carter D, Horn YE, Cornu P. Lumboperitoneal shunt and normal pressure hydrocephalus in elderly subjects. Rev Neurol (Paris) 1989;145:776-80.  Back to cited text no. 13  [PUBMED]  
14.Deen HG, Pettit PD, Sevin BU, Wharen RE, Reimer R. Lumbar peritoneal shunting with video-laparoscopic assistance: A useful technique for the management of refractory postoperative lumbar CSF leaks. Surg Neurol 2003;59:473-7;discussion 477-8.  Back to cited text no. 14  [PUBMED]  [FULLTEXT]
15.Huppert J, Bret P, Lapras C, Fischer G. Lumboperitoneal shunt in persistent or recurrent fistulae of the base of skull: Apropos of 20 cases. Neurochirurgie 1987;33:220-3.  Back to cited text no. 15  [PUBMED]  
16.Le H, Yamini B, Frim DM. Lumboperitoneal shunting as a treatment for slit ventricle syndrome. Pediatr Neurosurg 2002;36:178-82.  Back to cited text no. 16  [PUBMED]  [FULLTEXT]
17.Ide T, Aoki N, Miki Y. Slit ventricle syndrome successfully treated by a lumboperitoneal shunt. Neurol Res 1995;17:440-2.  Back to cited text no. 17  [PUBMED]  
18.Sood S, Barrett RJ, Powell T, Ham SD. The role of lumbar shunts in the management of slit ventricles: Does the slit-ventricle syndrome exist? J Neurosurg Pediatr2005;103:119-23.   Back to cited text no. 18    
19.Yadav YR. Cranio-cerebral erosion (growing skull fracture): Management by lumber-peritoneal shunt: Case report. Clin Pract Rev 2005;6:224-9.  Back to cited text no. 19    
20.Sharma RR, Chandy MJ. Shunt surgery in growing skull fracture report of two cases. Br J Neurosurg 1991;5:93-8.  Back to cited text no. 20  [PUBMED]  
21.Kashiwagi S, Abiko S, Aoki H. Growing skull fracture in childhood: A recurrent case treated by shunt operation. Surg Neurol 1986;26:63-6.  Back to cited text no. 21  [PUBMED]  
22.Fessler RD, Sobel J, Guyot L, Crane L, Vazquez J, Szuba MJ, et al. Management of elevated intracranial pressure in patients with Cryptococcal meningitis. J Acquir Immune Defic Syndr Hum Retrovirol 1998;17:37-42.  Back to cited text no. 22    
23.Kemaloglu S, Ozkan U, Bukte Y, Ceviz A, Ozates M. Timing of shunt surgery in childhood tuberculous meningitis with hydrocephalus. Pediatr Neurosurg 2002;37:194-8.  Back to cited text no. 23  [PUBMED]  [FULLTEXT]
24.Yadav YR, Mukerji G, Parihar V, Sinha M, Pandey S. Complex hydrocephalus (combination of communicating and obstructive type): An important cause of failed endoscopic third ventriculostomy. BMC Res Notes 2009;2:137.  Back to cited text no. 24  [PUBMED]  [FULLTEXT]
25.Riffaud L, Moughty C, Henaux PL, Haegelen C, Morandi X. Acquired chiari I malformation and syringomyelia after valveless lumboperitoneal shunt in infancy. Pediatr Neurosurg 2008;44:229-33.  Back to cited text no. 25  [PUBMED]  [FULLTEXT]
26.Vassilouthis J, Papandreou A, Anagnostaras S, Pappas J. Thecoperitoneal shunt for syringomyelia: Report of three cases. Neurosurgery 1993;33:324-7.  Back to cited text no. 26  [PUBMED]  [FULLTEXT]
27.Park TS, Cail WS, Broaddus WC, Walker MG. Lumboperitoneal shunt combined with myelotomy for treatment of syringohydromyelia. J Neurosurg 1989;70:721-7 Comment in: J Neurosurg 1989;71:950-3.  Back to cited text no. 27    
28.Shimizu S, Hagiwara H, Hattori S, Nakayama K, Fujii K. Change of patient position using a transportation board during lumboperitoneal shunting: Technical note. Neurol Med Chir (Tokyo) 2009;49:175-8.  Back to cited text no. 28  [PUBMED]  [FULLTEXT]
29.Kumar N, Bierbrauer KS, Grewal H. Microlaparoscopic-assisted lumboperitoneal shunt in the lateral position for pseudotumor cerebri in a morbidly obese adolescent. J Soc Laparoendoscp Surg 2006;10:267-9.  Back to cited text no. 29    
30.Hammers R, Prabhu VC, Sarker S, Jay WM. Laparoscopic-assisted lumboperitoneal shunt placement for idiopathic intracranial hypertension. Semin Ophthalmol 2008;23:151-5.  Back to cited text no. 30  [PUBMED]  [FULLTEXT]
31.Goitein D, Papasavas P, Gagnι D, Ferraro D, Wilder B, Caushaj P. Single trocar laparoscopically assisted placement of central nervous system-peritoneal shunts. J Laparoendosc Adv Surg Tech A 2006;16:1-4.  Back to cited text no. 31    
32.Kubo S, Ueno M, Takimoto H, Karasawa J, Kato A, Yoshimine T. Endoscopically aided retroperitoneal placement of a lumboperitoneal shunt: Technical note. J Neurosurg 2003;98:430-3.  Back to cited text no. 32  [PUBMED]  [FULLTEXT]
33.Hay SA, Hay AA, Moharram H, Salama M. Endoscopic implantation and patency evaluation of lumboperitoneal shunt: An innovative technique. Surg Endosc 2004;18:482-4.  Back to cited text no. 33  [PUBMED]  [FULLTEXT]
34.Kavic SM, Segan RD, Taylor MD, Roth JS. Laparoscopic management of ventriculoperitoneal and lumboperitoneal shunt complications. J Soc Laparoendoscp Surg 2007;11:14-9.  Back to cited text no. 34    
35.Ishiwata Y. Analysis of CSF flow through L-P shunt during changes in posture. No Shinkei Geka 1989;17:351-8.  Back to cited text no. 35  [PUBMED]  
36.West CG, Grebbell FS. A means of assessing theco-peritoneal shunt patency. Br J Radiol 1980;53:647-9.  Back to cited text no. 36  [PUBMED]  
37.Ishiwata Y, Chiba Y, Yamashita T, Gondo G, Ide K, Kuwabara T. Thermosensitive determination of patency in lumboperitoneal shunts: Technical note. J Neurosurg 1989;70:143-5.  Back to cited text no. 37  [PUBMED]  [FULLTEXT]
38.Wang VY, Barbaro NM, Lawton MT, Pitts L, Kunwar S, Parsa AT, et al. Complications of lumboperitoneal shunts. Neurosurgery 2007;60:1045-8;discussion 1049.  Back to cited text no. 38  [PUBMED]  [FULLTEXT]
39.Rekate HL, Wallace D. Lumboperitoneal shunts in children. Pediatr Neurosurg 2003;38:41-6.  Back to cited text no. 39  [PUBMED]  [FULLTEXT]
40.Kim BN, Kim JM, Kang SD. Comparison of clinical usefulness of lumboperitoneal shunt with ventriculoperitoneal shunt for treating chronic hydrocephalus in ruptured intracranial aneurysm. J Korean Neurosurg Soc 1998;27:947-52.  Back to cited text no. 40    
41.Liu GT, Volpe NJ, Schatz NJ, Galetta SL, Farrar JT, Raps EC. Severe sudden visual loss caused by pseudotumor cerebri and lumboperitoneal shunt failure. Am J Ophthalmol 1996;122:129-31.  Back to cited text no. 41  [PUBMED]  
42.Lam FC, Wheatley MB, Mehta V. Treatment of secondary tonsillar herniation by lumboperitoneal shunt revision. Can J Neurol Sci 2007;34:237-42.  Back to cited text no. 42  [PUBMED]  [FULLTEXT]
43.Liao YJ, Dillon WP, Chin CT, McDermott MW, Horton JC. Intracranial hypotension caused by leakage of cerebrospinal fluid from the thecal sac after lumboperitoneal shunt placement: Case report. J Neurosurg 2007;107: 173-7.  Back to cited text no. 43  [PUBMED]  [FULLTEXT]
44.Mirza S, Saeed SR, Ramsden RT. Extensive tension pneumocephalus complicating continuous lumbar CSF drainage for the management of CSF rhinorrhoea. ORL J Otorhinolaryngol Relat Spec 2003;65:215-8.  Back to cited text no. 44  [PUBMED]  [FULLTEXT]
45.Kamiryo T, Hamada J, Fuwa I, Ushio Y. Acute subdural hematoma after lumboperitoneal shunt placement in patients with normal pressure hydrocephalus. Neurol Med Chir (Tokyo) 2003;43:197-200.  Back to cited text no. 45  [PUBMED]  [FULLTEXT]
46.Yoshida S, Masunaga S, Hayase M, Oda Y. Migration of the shunt tube after lumboperitoneal shunt-two case reports. Neurol Med Chir (Tokyo) 2000;40:594-6.  Back to cited text no. 46  [PUBMED]  [FULLTEXT]
47.Kanai M, Kawano K, Uehara S. Upward migration of the LP shunt catheter into the cranial base. Osaka City Med J 1999;45:123-7.  Back to cited text no. 47  [PUBMED]  
48.Alleyne CH Jr, Shutter LA, Colohan AR. Cranial migration of a lumboperitoneal shunt catheter. South Med J 1996;89:634-6.  Back to cited text no. 48  [PUBMED]  [FULLTEXT]
49.McIvor J, Krajbich JI, Hoffman H. Orthopaedic complications of lumboperitoneal shunts. J Pediatr Orthop 1988;8:687-9.  Back to cited text no. 49  [PUBMED]  
50.Suri A, Pandey P, Mehta VS. Subarachnoid hemorrhage and intracereebral hematoma following lumboperitoneal shunt for pseudotumor cerebri: A rare complication. Neurology India 2002;50:508-10.  Back to cited text no. 50  [PUBMED]  
51.Duthel R, Nuti C, Motuo-Fotso MJ, Beauchesne P, Brunon J. Complications of lumboperitoneal shunts: A retrospective study of a series of 195 patients (214 procedures). Neurochirurgie 1996;42:83-9;discussion 89-90.  Back to cited text no. 51  [PUBMED]  
52.Nadkarni TD, Rekate HL, Wallace D. Concurrent use of a lumboperitoneal shunt with programmable valve and ventricular access device in the treatment of pseudotumor cerebri: Review of 40 cases. J Neurosurg Pediatr 2008;2:19-24.  Back to cited text no. 52  [PUBMED]  [FULLTEXT]

Copyright 2010 - Neurology India

The following images related to this document are available:

Photo images

Home Faq Resources Email Bioline
© Bioline International, 1989 - 2024, Site last up-dated on 01-Sep-2022.
Site created and maintained by the Reference Center on Environmental Information, CRIA, Brazil
System hosted by the Google Cloud Platform, GCP, Brazil