Mohammad W Kassem1,2, Joshua Chern3,4, Marios Loukas5, R Shane Tubbs6,5. 1. Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA. moody.kassem@gmail.com. 2. Department of Anatomical Sciences, St. George's University, True Blue, Grenada. moody.kassem@gmail.com. 3. Pediatric Neurosurgery Associates, Children's Healthcare of Atlanta, Atlanta, GA, USA. 4. Department of Neurosurgery, Emory University, Atlanta, GA, USA. 5. Department of Anatomical Sciences, St. George's University, True Blue, Grenada. 6. Seattle Science Foundation, 550 17th Avenue, Suite 600, Seattle, WA, 98122, USA.
Abstract
PURPOSE: Intraosseous (IO) vascular access has been used since the Second World War and is warranted when there is an emergency and/or urgent need to replenish the vascular pool. Despite long-term and satisfactory results from delivering large quantities of intravenous fluid via the medullary space of bone, use of this space for a distant receptacle for cerebrospinal fluid (CSF) diversion has seldom been considered. METHODS: The current paper reviews the literature regarding the bony medullary space as a receptacle for intravenous fluid and CSF. RESULTS: Previous authors have demonstrated the potential of the diploic space of the calvaria for CSF shunting. Pugh and colleagues tested the ability of the cranium to receive and absorb a small amount of tracer fluid. CONCLUSION: The literature suggests that intraosseous placement of ventricular diversionary shunts is an alternative to more traditional sites such as the pleural cavity and peritoneum. When these latter locations are not available or are contraindicated, placement in the medullary space of bone is another option available to the surgeon.
PURPOSE: Intraosseous (IO) vascular access has been used since the Second World War and is warranted when there is an emergency and/or urgent need to replenish the vascular pool. Despite long-term and satisfactory results from delivering large quantities of intravenous fluid via the medullary space of bone, use of this space for a distant receptacle for cerebrospinal fluid (CSF) diversion has seldom been considered. METHODS: The current paper reviews the literature regarding the bony medullary space as a receptacle for intravenous fluid and CSF. RESULTS: Previous authors have demonstrated the potential of the diploic space of the calvaria for CSF shunting. Pugh and colleagues tested the ability of the cranium to receive and absorb a small amount of tracer fluid. CONCLUSION: The literature suggests that intraosseous placement of ventricular diversionary shunts is an alternative to more traditional sites such as the pleural cavity and peritoneum. When these latter locations are not available or are contraindicated, placement in the medullary space of bone is another option available to the surgeon.
Authors: Ulises García-González; Daniel D Cavalcanti; Abhishek Agrawal; L Fernando Gonzalez; Robert C Wallace; Robert F Spetzler; Mark C Preul Journal: Neurosurg Focus Date: 2009-11 Impact factor: 4.047
Authors: R Shane Tubbs; David Bauer; M Renee Chambers; Marios Loukas; Mohammadali M Shoja; Aaron A Cohen-Gadol Journal: Neurosurgery Date: 2011-02 Impact factor: 4.654
Authors: Mohammad W Kassem; Basem Ishak; Karishma Mehta; Joe Iwanaga; Marios Loukas; R Shane Tubbs Journal: Childs Nerv Syst Date: 2019-05-04 Impact factor: 1.475