Ventriculo-pleural shunting for adult hydrocephalus.

In order to evaluate the efficacy and safety of ventriculo-pleural shunting as an alternative to conventional atrial and peritoneal procedures, we have carried out a retrospective study of 88 pleural shunting procedures. There was a 7% complication rate related to the use of the pleural space as the shunt terminus. Complications at the pleural end included shunt obstruction (functional or structural), pleural effusion, pneumothorax, and other technical problems. There were no deaths associated with shunt dysfunction or other complications. Ventriculo-pleural shunting for hydrocephalus, when used with appropriate precautions and with careful patient selection is a viable alternative for the treatment of adult hydrocephalus. The complications that are unique to this procedure are pneumothorax and pleural effusion. They were encountered infrequently in this series. Ventriculo-pleural shunting may be indicated when other routes are not available.