Biological reactions to cerebrospinal fluid shunt devices: A review of the cellular pathology

OBJECTIVE: To understand the interaction between cerebrospinal fluid shunt components and the brain and other tissues. METHODS: A systematic review of the medical literature directly pertaining to shunt complications, and that dealing with tissues' reactions to implants in general, was conducted. RESULTS: Vascularized pedicles of glial tissue or choroid plexus grow into ventricular catheters, primarily as a mechanical phenomenon. Cellular debris or blood can cause dysfunction of valve components. Chronic inflammation, which is nonspecific, might contribute to degradation of the components. CONCLUSION: Care must be taken to prevent early entry of debris or blood into the shunt system. Ventricular collapse onto the shunt must be avoided. Refinement of manufacturing methods or modification of shunt materials could reduce the susceptibility of shunts to infection and improve longevity of the apparatus.