Muzamil Dilber, Abdul Razaq Mari, Hamid Akbabr Shaikh, Fahmida Arab Mallah, Ali Raza Brohi.
Outcome of Ventriculo-Atrial Shunt as a Third Option in the Treatment of Hydrocephalu.
Pak J Neuro Surg Jan ;21(4):193-7.

Objective: The purpose of this study is to describe outcome of ventriculoatrial shunt as a third option in the treatment of hydrocephalus. Design: Descriptive case series study. Place and Duration of Study: Neurosurgery department Peoples University of Medical and Health Sciences Nawabshah, from January 2013 to December 2015. Materials and Methods: This study was conducted on patients who have already attempted for VP shunt and ETV and both have failed. Under radiological guidance distal end of catheter was placed in right atrium at D6 level. Jugular vein was cannulated via common facial vein or direct puncture. Results: Over a period of 3 years, 24 patients were operated for VA shunt. There were 16 (66.66%) males and 8 (33.33%) females. Male to female ratio was 2:1. Age groups included 2 years to 18 years (mean 9.17 median 8 SD +/- 5.55). Mostly left side was used and common facial venesection was preferred to direct puncture of jugular vein. One patient developed shunt nephritis which was managed with Vancomycin. Conclusion: VA shunt can be used as third option in the treatment of hydrocephalus taking great care of its complications. Abbreviations: ETV: Endoscopic Third Ventriculostomy. VCS: Ventriculocisternostomy. CSF: Cerebral Scleral Fluid.

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