Insertion of ventriculoperitoneal and ventriculovenous cerebrospinal fluid shunts

This article describes a technique for insertion of ventriculoperitoneal and ventriculovenous cerebrospinal fluid (CSF) shunts for treatment of hydrocephalus. There is an evidentiary basis for few of the decisions that must be made in CSF shunt surgery. In matters unilluminated by evidence, popular options that differ from the author's technique receive consideration as well. Computer-assisted image guidance and intraoperative ultrasound deserve further investigation and, perhaps, incorporation into the routine of ventricular catheter insertion and revision.