Numerous diseases cause accumulation of CSF in the cranial cavity which may range from congenital to obstruction by tumours. In a large number of these conditions, diversion of cerebrospinal fluid is warranted to relieve pressure on the brain and relieve symptoms. CSF diversion may be performed by use of a shunt or by using endoscopic methods to create internal bypasses depending on the situation. In a large number of patients, the shunt is still the preferred method of diverting CSF, most often into the peritoneal cavity. A ventricular peritoneal shunt carries several drawbacks and potential complications some of which are infection, migration of the shunt, over drainage, under drainage, shunt obstruction, etc.
Very often these situations might warrant a revision, exteriorisation or removal of the shunt altogether. With the advent of programmable shunts and the ability that it brings to manipulate valve pressure without surgical revision, the incidents of shunt revisions have drastically reduced, thereby minimising patient morbidity and thereby mortality too. Shunt reprogramming can be done as an outpatient procedure without the need for any anaesthesia and most often yields immediate symptomatic improvement to the patient.
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