VENTRICULOPLEURAL SHUNTING USED AS A TEMPORARY DIVERSION

Due to the limited absorptive capacity of the pleural cavity, infants and young children are not generally ideal candidates for ventriculopl eural shunts. We report using chest cavities as alternate for temporar y diversion of CSF in a young child. Venous access to the cervical reg ion could not be utilized because of scarring from previous procedures , while peritoneal access was contraindicated due to repeated pseudocy st formation. Pleural effusions were removed by thoracentesis when nec essary, and the shunt catheter was changed to the opposite side of the chest when the effusions reaccumulated within one week. Utilizing the ventriculopleural shunts allowed us to temporize her non-communicatin g hydrocephalus for a period of one year, until a definitive CSF proce dure by direct intracardiac placement of the distal catheter could be performed.