REVERSIBLE OCCLUSION SHUNT FOR INTRAVENTRICULAR CHEMOTHERAPY IN SHUNT-DEPENDENT BRAIN-TUMOR PATIENTS

Intraventricular chemotherapy is increasingly used in the treatment of pediatric brain tumors with leptomeningeal seeding. However, some pat ients are shunt dependent after surgery, probably due to adhesions in the area of surgery. To avoid drug diversion in these patients we conn ected the reservoir to a reversible occlusion device. Over a 2-year pe riod a shunt valve with an on-off device was inserted into the shunt a ssembly of eight children with various brain tumors with a pow prognos is undergoing intraventricular chemotherapy. All eight patients had tu mor cells in the ventricular cerebrospinal fluid (CSF) and/or metastas es by magnetic resonance imaging The number of intraventricular drug a pplications ranged from 10 to 51. No shunt malfunctions or shunt-relat ed infections occurred. The temporary closure of the shunt after drug delivery was well tolerated. In all sir children with tumor cells in t he ventricular CSF a negative cytology teas achieved over a 3- to 8-we ek period.