Right Transcephalic Ventriculo-Subclavian Shunt in the Surgical Treatment of Hydrocephalus—An Original Procedure for Drainage of Cerebrospinal Fluid into the Venous System

Abstract

The objectives of this article are to present an original surgical procedure for the temporary or definitive resolution of hydrocephalus, in the case of repeated failure of standard treatment techniques, and to present a case that was resolved using this surgical technique. Materials and methods: We present the case of a 20-year-old male patient with congenital hydrocephalus who underwent a number of 39 shunt revisions, given the repetitive dysfunctions of various techniques (ventriculo-peritoneal shunt, ventriculo-cardiac shunt). The patient was evaluated with the ventricular catheter externalized at the distal end and it was necessary to find an emergency surgical solution, considering the imminent risk of meningitis. The patient was also associated with the diagnosis of acute lithiasic cholecystitis. Results and discussions: The final chosen solution, right ventriculo-venous drainage using the cephalic vein, was a temporary surgical solution, but there are signs that this procedure can provide long-term ventricular drainage. Conclusions: Transcephalic ventriculo-subclavian drainage represents an alternative technical option, which can be used when established options become ineffective.