BIOLOGICAL REACTIONS TO CEREBROSPINAL-FLUID SHUNT DEVICES - A REVIEW OF THE CELLULAR PATHOLOGY

OBJECTIVE: To understand the interaction between cerebrospinal fluid s hunt components and the brain and other tissues. METHODS: A systematic review of the medical literature directly pertaining to shunt complic ations, and that dealing with tissues' reactions to implants in genera l, was conducted. RESULTS: Vascularized pedicles of glial tissue or ch oroid plexus grow into ventricular catheters, primarily as a mechanica l phenomenon. Cellular debris or blood can cause dysfunction of valve components. Chronic inflammation, which is nonspecific, might contribu te to degradation of the components. CONCLUSION: Care must be taken to prevent early entry of debris or blood into the shunt system. Ventric ular collapse onto the shunt must be avoided. Refinement of manufactur ing methods or modification of shunt materials could reduce the suscep tibility of shunts to infection and improve longevity of the apparatus .