Shunt independence [Neurosurgery Wiki]

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====== Shunt independence ======

The concept of becoming independent of a shunt is not universally accepted
((Foltz EL, Shurtleff DB. Five-Year Comparative Study of Hydrocephalus in Children with and without Operation (113 Cases). J Neurosurg. 1963; 20: 1064–1079)).

Some feel that shunt independence occurs more commonly when the [[hydrocephalus]] is due to a block at the level of the [[arachnoid granulation]]s (communicating hydrocephalus),
((Rekate HL, Nulsen FE, Mack HL, et al. Establishing the Diagnosis of Shunt Independence. Monogr Neural Sci. 1982; 8:223–226))
but others have shown that it can occur regardless of the etiology
((Holtzer GJ, De Lange SA. Shunt-Independent Arrest of Hydrocephalus. J Neurosurg. 1973; 39: 698–701)).
These patients must be followed closely, as there are reports of death as late as 5 years after apparent shunt independence, sometimes without warning
((Rekate HL, Nulsen FE, Mack HL, et al. Establishing the Diagnosis of Shunt Independence. Monogr Neural Sci. 1982; 8:223–226)).