{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:26:03Z","timestamp":1794014763095,"version":"4.8.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Cerebrospinal fluid (CSF) shunting in idiopathic intracranial hypertension (IIH) is associated with high complication rates, primarily because of the technical challenges that are related to small ventricles and a large body habitus. In this study, the authors report the benefits of a standardized protocol for CSF shunting in patients with IIH as relates to shunt revisions.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This was a retrospective study of consecutive patients with IIH who had undergone primary insertion of a CSF shunt between January 2014 and December 2020 at the authors\u2019 hospital. In July 2019, they implemented a surgical protocol for shunting in IIH. This protocol recommended IIH shunt insertion by neurosurgeons with expertise in CSF disorders, a frontal ventriculoperitoneal (VP) shunt with an adjustable gravitational valve and integrated intracranial pressure monitoring device, frameless stereotactic insertion of the ventricular catheter, and laparoscopic insertion of the peritoneal catheter. Thirty-day revision rates before and after implementation of the protocol were compared in order to assess the impact of standardizing shunting for IIH on shunt complications.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n The 81 patients included in the study were predominantly female (93%), with a mean age of 31 years at primary surgery and mean body mass index (BMI) of 37 kg\/m\n 2<\/jats:sup>\n . Forty-five patients underwent primary surgery prior to implementation of the protocol and 36 patients after. Overall, 12 (15%) of 81 patients needed CSF shunt revision in the first 30 days, 10 before and 2 after introduction of the protocol. This represented a significant reduction in the early revision rate from 22% to 6% after the protocol (p = 0.036). The most common cause of shunt revision for the whole cohort was migration or misplacement of the peritoneal catheter, occurring in 6 of the 12 patients. Patients with a higher BMI were significantly more likely to have a shunt revision within 30 days (p = 0.022).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The Birmingham standardized IIH shunt protocol resulted in a significant reduction in revisions within 30 days of primary shunt surgery in patients with IIH. The authors recommend standardization for shunting in IIH as a method for improving surgical outcomes. They support the notion of subspecialization for IIH shunts, the use of a frontal VP shunt with sophisticated technology, and laparoscopic insertion of the peritoneal end.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2021.5.jns21821","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T04:05:30Z","timestamp":1634875530000},"page":"1790-1795","source":"Crossref","is-referenced-by-count":18,"title":["Cerebrospinal fluid shunting protocol for idiopathic intracranial hypertension for an improved revision rate"],"prefix":"10.3171","volume":"136","author":[{"given":"Luke","family":"Galloway","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishan","family":"Karia","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwen M.","family":"White","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian E.","family":"Byrne","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra J.","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Neurology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham;"},{"name":"Institute of Metabolism and Systems Research, University of Birmingham; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan P.","family":"Mollan","sequence":"additional","affiliation":[{"name":"Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Tsermoulas","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Institute of Metabolism and Systems Research, University of Birmingham; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"12","key":"b1","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"3776","DOI":"10.1007\/s00415-020-10090-4","article-title":"Emerging themes in idiopathic intracranial hypertension","volume":"267","author":"Grech O","year":"2020","unstructured":"Grech O, Mollan SP, Wakerley BR, Alimajstorovic Z, Lavery GG, Sinclair AJ. Emerging themes in idiopathic intracranial hypertension. J Neurol. 2020;267(12):3776\u20133784.3270001210.1007\/s00415-020-10090-4"},{"issue":"1","key":"b2","series-title":"Lancet Neurol","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/S1474-4422(15)00298-7","article-title":"Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions","volume":"15","author":"Markey KA","year":"2016","unstructured":"Markey KA, Mollan SP, Jensen RH, Sinclair AJ. Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. Lancet Neurol. 2016;15(1):78\u201391.2670090710.1016\/S1474-4422(15)00298-7"},{"issue":"1","key":"b3","series-title":"J Headache Pain","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s10194-018-0919-2","article-title":"European headache federation guideline on idiopathic intracranial hypertension","volume":"19","author":"Hoffmann J","year":"2018","unstructured":"Hoffmann J, Mollan SP, Paemeleire K, Lampl C, Jensen RH, Sinclair AJ. European headache federation guideline on idiopathic intracranial hypertension. J Headache Pain. 2018;19(1):93.3029834610.1186\/s10194-018-0919-2"},{"issue":"3","key":"b4","series-title":"Eye (Lond)","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1038\/s41433-018-0238-5","article-title":"The expanding burden of idiopathic intracranial hypertension","volume":"33","author":"Mollan SP","year":"2019","unstructured":"Mollan SP, Aguiar M, Evison F, Frew E, Sinclair AJ. The expanding burden of idiopathic intracranial hypertension. Eye (Lond). 2019;33(3):478\u2013485.10.1038\/s41433-018-0238-530356129"},{"issue":"10","key":"b5","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1136\/jnnp-2017-317440","article-title":"Idiopathic intracranial hypertension: consensus guidelines on management","volume":"89","author":"Mollan SP","year":"2018","unstructured":"Mollan SP, Davies B, Silver NC, Shaw S, Mallucci CL, Idiopathic intracranial hypertension: consensus guidelines on management. J Neurol Neurosurg Psychiatry. 2018;89(10):1088\u20131100.2990390510.1136\/jnnp-2017-317440"},{"issue":"1","key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"170","DOI":"10.3171\/2014.4.JNS13944","article-title":"Analysis of 30-day readmissions among neurosurgical patients: surgical complication avoidance as key to quality improvement","volume":"121","author":"Buchanan CC","year":"2014","unstructured":"Buchanan CC, Hernandez EA, Anderson JM, Dye JA, Leung M, Analysis of 30-day readmissions among neurosurgical patients: surgical complication avoidance as key to quality improvement. J Neurosurg. 2014;121(1):170\u2013175.2483494210.3171\/2014.4.JNS13944"},{"key":"b7","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.clineuro.2015.05.018","article-title":"Management of idiopathic intracranial hypertension with a programmable lumboperitoneal shunt: early experience","volume":"136","author":"Alkherayf F","year":"2015","unstructured":"Alkherayf F, Abou Al-Shaar H, Awad M. Management of idiopathic intracranial hypertension with a programmable lumboperitoneal shunt: early experience. Clin Neurol Neurosurg. 2015;136:5\u20139.2605680410.1016\/j.clineuro.2015.05.018"},{"issue":"11","key":"b8","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1136\/jnnp.2007.141416","article-title":"Perioperative risk factors for short term shunt revisions in adult hydrocephalus patients","volume":"80","author":"Farahmand D","year":"2009","unstructured":"Farahmand D, Hilmarsson H, H\u00f6gfeldt M, Tisell M. Perioperative risk factors for short term shunt revisions in adult hydrocephalus patients. J Neurol Neurosurg Psychiatry. 2009;80(11):1248\u20131253.1929317410.1136\/jnnp.2007.141416"},{"issue":"16","key":"b9","series-title":"Cephalalgia","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.1177\/0333102411423305","article-title":"Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review","volume":"31","author":"Sinclair AJ","year":"2011","unstructured":"Sinclair AJ, Kuruvath S, Sen D, Nightingale PG, Burdon MA, Flint G. Is cerebrospinal fluid shunting in idiopathic intracranial hypertension worthwhile? A 10-year review. Cephalalgia. 2011;31(16):1627\u20131633.2196851910.1177\/0333102411423305"},{"issue":"4","key":"b10","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"391","DOI":"10.3171\/2015.8.PEDS15253","article-title":"A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection","volume":"17","author":"Kestle JRW","year":"2016","unstructured":"Kestle JRW, Holubkov R, Douglas Cochrane D, Kulkarni AV, Limbrick DD Jr, A new Hydrocephalus Clinical Research Network protocol to reduce cerebrospinal fluid shunt infection. J Neurosurg Pediatr. 2016;17(4):391\u2013396.2668476310.3171\/2015.8.PEDS15253"},{"issue":"3","key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"755","DOI":"10.3171\/2018.10.JNS181432","article-title":"Detailed standardized protocol to prevent cerebrospinal fluid shunt infection","volume":"132","author":"Okamura Y","year":"2019","unstructured":"Okamura Y, Maruyama K, Fukuda S, Horikawa H, Sasaki N, Detailed standardized protocol to prevent cerebrospinal fluid shunt infection. J Neurosurg. 2019;132(3):755\u2013759.3077177110.3171\/2018.10.JNS181432"},{"issue":"13","key":"b12","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1159","DOI":"10.1212\/WNL.0b013e3182a55f17","article-title":"Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children","volume":"81","author":"Friedman DI","year":"2013","unstructured":"Friedman DI, Liu GT, Digre KB. Revised diagnostic criteria for the pseudotumor cerebri syndrome in adults and children. Neurology. 2013;81(13):1159\u20131165.2396624810.1212\/WNL.0b013e3182a55f17"},{"issue":"4","key":"b13","series-title":"J Neurosurg","first-page":"1252","article-title":"Comparative durability and costs analysis of ventricular shunts","volume":"130","author":"Agarwal N","year":"2019","unstructured":"Agarwal N, Kashkoush A, McDowell MM, Lariviere WR, Ismail N, Friedlander RM. Comparative durability and costs analysis of ventricular shunts. J Neurosurg. 2019;130(4):1252\u20131259."},{"key":"b14","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1016\/j.wneu.2016.10.136","article-title":"The rate of complications after ventriculoperitoneal shunt surgery","volume":"98","author":"Merkler AE","year":"2017","unstructured":"Merkler AE, Ch\u2019ang J, Parker WE, Murthy SB, Kamel H. The rate of complications after ventriculoperitoneal shunt surgery. World Neurosurg. 2017;98:654\u2013658.2782608610.1016\/j.wneu.2016.10.136"},{"issue":"7","key":"b15","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1136\/jnnp-2018-319927","article-title":"Current epidemiology of cerebrospinal fluid shunt surgery in the UK and Ireland (2004-2013)","volume":"90","author":"Fern\u00e1ndez-M\u00e9ndez R","year":"2019","unstructured":"Fern\u00e1ndez-M\u00e9ndez R, Richards HK, Seeley HM, Pickard JD, Joannides AJ. Current epidemiology of cerebrospinal fluid shunt surgery in the UK and Ireland (2004-2013). J Neurol Neurosurg Psychiatry. 2019;90(7):747\u2013754.3091085810.1136\/jnnp-2018-319927"},{"issue":"9","key":"b16","series-title":"JAMA Neurol","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1001\/jamaneurol.2019.1812","article-title":"Association between idiopathic intracranial hypertension and risk of cardiovascular diseases in women in the United Kingdom","volume":"76","author":"Adderley NJ","year":"2019","unstructured":"Adderley NJ, Subramanian A, Nirantharakumar K, Yiangou A, Gokhale KM, Association between idiopathic intracranial hypertension and risk of cardiovascular diseases in women in the United Kingdom. JAMA Neurol. 2019;76(9):1088\u20131098.3128295010.1001\/jamaneurol.2019.1812"},{"issue":"7","key":"b17","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1136\/jnnp-2020-325519","article-title":"Negative impact of COVID-19 lockdown on papilloedema and idiopathic intracranial hypertension","volume":"92","author":"Thaller M","year":"2021","unstructured":"Thaller M, Tsermoulas G, Sun R, Mollan SP, Sinclair AJ. Negative impact of COVID-19 lockdown on papilloedema and idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry. 2021;92(7):795\u2013797.3336141110.1136\/jnnp-2020-325519"},{"issue":"1","key":"b18","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"145","DOI":"10.3171\/2017.8.JNS17399","article-title":"Factors associated with 30-day ventriculoperitoneal shunt failure in pediatric and adult patients","volume":"130","author":"Anderson IA","year":"2018","unstructured":"Anderson IA, Saukila LF, Robins JMW, Akhunbay-Fudge CY, Goodden JR, Factors associated with 30-day ventriculoperitoneal shunt failure in pediatric and adult patients. J Neurosurg. 2018;130(1):145\u2013153.2952159210.3171\/2017.8.JNS17399"},{"issue":"1","key":"b19","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1093\/neuros\/nyz379","article-title":"Shunt failure\u2014the first 30 days","volume":"87","author":"Lee RP","year":"2020","unstructured":"Lee RP, Ajmera S, Thomas F, Dave P, Lillard JC, Shunt failure\u2014the first 30 days. Neurosurgery. 2020;87(1):123\u2013129.3155729810.1093\/neuros\/nyz379"},{"issue":"1","key":"b20","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"94","DOI":"10.3109\/02688697.2010.544781","article-title":"Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts\u2014case series and literature review","volume":"25","author":"Abubaker K","year":"2011","unstructured":"Abubaker K, Ali Z, Raza K, Bolger C, Rawluk D, O\u2019Brien D. Idiopathic intracranial hypertension: lumboperitoneal shunts versus ventriculoperitoneal shunts\u2014case series and literature review. Br J Neurosurg. 2011;25(1):94\u201399.2132340410.3109\/02688697.2010.544781"},{"issue":"6","key":"b21","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1227\/01.NEU.0000255456.12978.31","article-title":"Stereotactic ventriculoperitoneal shunting for refractory idiopathic intracranial hypertension","volume":"60","author":"Abu-Serieh B","year":"2007","unstructured":"Abu-Serieh B, Ghassempour K, Duprez T, Raftopoulos C. Stereotactic ventriculoperitoneal shunting for refractory idiopathic intracranial hypertension. Neurosurgery. 2007;60(6):1039\u20131044.1753837710.1227\/01.NEU.0000255456.12978.31"},{"issue":"1","key":"b22","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1080\/02688697.2018.1538478","article-title":"Ventriculo-peritoneal shunting is a safe and effective treatment for idiopathic intracranial hypertension","volume":"33","author":"Bjornson A","year":"2019","unstructured":"Bjornson A, Tapply I, Nabbanja E, Lalou AD, Czosnyka M, Ventriculo-peritoneal shunting is a safe and effective treatment for idiopathic intracranial hypertension. Br J Neurosurg. 2019;33(1):62\u201370.3065336910.1080\/02688697.2018.1538478"},{"issue":"2","key":"b23","series-title":"J Neuroophthalmol","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1097\/WNO.0000000000000922","article-title":"Complications of ventriculoperitoneal shunt for idiopathic intracranial hypertension: a single-institution study of 32 patients","volume":"41","author":"Brune AJ","year":"2021","unstructured":"Brune AJ, Girgla T, Trobe JD. Complications of ventriculoperitoneal shunt for idiopathic intracranial hypertension: a single-institution study of 32 patients. J Neuroophthalmol. 2021;41(2):224\u2013232.3223522610.1097\/WNO.0000000000000922"},{"issue":"2","key":"b24","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/s10143-011-0350-5","article-title":"Lumboperitoneal shunt for idiopathic intracranial hypertension: patients\u2019 selection and outcome","volume":"35","author":"El-Saadany WF","year":"2012","unstructured":"El-Saadany WF, Farhoud A, Zidan I. Lumboperitoneal shunt for idiopathic intracranial hypertension: patients\u2019 selection and outcome. Neurosurg Rev. 2012;35(2):239\u2013244.2195636110.1007\/s10143-011-0350-5"},{"issue":"6","key":"b25","series-title":"Neuroophthalmology","doi-asserted-by":"publisher","first-page":"310","DOI":"10.3109\/01658107.2014.956183","article-title":"Visual outcomes from shunting for idiopathic intracranial hypertension","volume":"38","author":"Hickman SJ","year":"2014","unstructured":"Hickman SJ, Raoof N, Panesar H, McMullan JM, Pepper IM, Sharrack B. Visual outcomes from shunting for idiopathic intracranial hypertension. Neuroophthalmology. 2014;38(6):310\u2013319.2792831810.3109\/01658107.2014.956183"},{"issue":"3","key":"b26","series-title":"J Neuroophthalmol","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1097\/WNO.0000000000000106","article-title":"Ventriculoperitoneal shunt as a treatment of visual loss in idiopathic intracranial hypertension","volume":"34","author":"Huang LC","year":"2014","unstructured":"Huang LC, Winter TW, Herro AM, Rosa PR, Schiffman JC, Ventriculoperitoneal shunt as a treatment of visual loss in idiopathic intracranial hypertension. J Neuroophthalmol. 2014;34(3):223\u2013228.2463791110.1097\/WNO.0000000000000106"},{"issue":"1","key":"b27","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"136","DOI":"10.3171\/2017.8.JNS162927","article-title":"Treatment of idiopathic intracranial hypertension via stereotactic placement of biventriculoperitoneal shunts","volume":"130","author":"Karsy M","year":"2018","unstructured":"Karsy M, Abou-Al-Shaar H, Bowers CA, Schmidt RH. Treatment of idiopathic intracranial hypertension via stereotactic placement of biventriculoperitoneal shunts. J Neurosurg. 2018;130(1):136\u2013144.2939375210.3171\/2017.8.JNS162927"},{"issue":"6","key":"b28","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.clineuro.2011.02.008","article-title":"Is there a difference in outcomes of patients with idiopathic intracranial hypertension with the choice of cerebrospinal fluid diversion site: a single centre experience","volume":"113","author":"Tarnaris A","year":"2011","unstructured":"Tarnaris A, Toma AK, Watkins LD, Kitchen ND. Is there a difference in outcomes of patients with idiopathic intracranial hypertension with the choice of cerebrospinal fluid diversion site: a single centre experience. Clin Neurol Neurosurg. 2011;113(6):477\u2013479.10.1016\/j.clineuro.2011.02.008"},{"issue":"1","key":"b29","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1159\/000084059","article-title":"Frameless stereotactic ventricular shunt placement for idiopathic intracranial hypertension","volume":"83","author":"Woodworth GF","year":"2005","unstructured":"Woodworth GF, McGirt MJ, Elfert P, Sciubba DM, Rigamonti D. Frameless stereotactic ventricular shunt placement for idiopathic intracranial hypertension. Stereotact Funct Neurosurg. 2005;83(1):12\u201316.1572410910.1159\/000084059"},{"issue":"4","key":"b30","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"627","DOI":"10.3171\/jns.2004.101.4.0627","article-title":"Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes","volume":"101","author":"McGirt MJ","year":"2004","unstructured":"McGirt MJ, Woodworth G, Thomas G, Miller N, Williams M, Rigamonti D. Cerebrospinal fluid shunt placement for pseudotumor cerebri-associated intractable headache: predictors of treatment response and an analysis of long-term outcomes. J Neurosurg. 2004;101(4):627\u2013632.10.3171\/jns.2004.101.4.0627"},{"issue":"3","key":"b31","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2015.12.FOCUS15583","article-title":"Optimizing ventriculoperitoneal shunt placement in the treatment of idiopathic intracranial hypertension: an analysis of neuroendoscopy, frameless stereotaxy, and intraoperative CT","volume":"40","author":"Yim B","year":"2016","unstructured":"Yim B, Reid Gooch M, Dalfino JC, Adamo MA, Kenning TJ. Optimizing ventriculoperitoneal shunt placement in the treatment of idiopathic intracranial hypertension: an analysis of neuroendoscopy, frameless stereotaxy, and intraoperative CT. Neurosurg Focus. 2016;40(3):E12.2692605210.3171\/2015.12.FOCUS15583"},{"issue":"6","key":"b32","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/S0090-3019(99)00086-5","article-title":"Survey on neurosurgery subspecialty fellowship training","volume":"52","author":"Lee TT","year":"1999","unstructured":"Lee TT, Klose JL. Survey on neurosurgery subspecialty fellowship training. Surg Neurol. 1999;52(6):641\u2013645.1066003510.1016\/S0090-3019(99)00086-5"},{"issue":"11","key":"b33","series-title":"Br J Cancer","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1038\/bjc.2016.317","article-title":"Surgeon volume and 30 day mortality for brain tumours in England","volume":"115","author":"Williams M","year":"2016","unstructured":"Williams M, Treasure P, Greenberg D, Brodbelt A, Collins P. Surgeon volume and 30 day mortality for brain tumours in England. Br J Cancer. 2016;115(11):1379\u20131382.2776484310.1038\/bjc.2016.317"},{"issue":"6","key":"b34","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"726","DOI":"10.3171\/2015.6.PEDS15184","article-title":"The effect of weekend and after-hours surgery on morbidity and mortality rates in pediatric neurosurgery patients","volume":"16","author":"Desai V","year":"2015","unstructured":"Desai V, Gonda D, Ryan SL, Brice\u00f1o V, Lam SK, The effect of weekend and after-hours surgery on morbidity and mortality rates in pediatric neurosurgery patients. J Neurosurg Pediatr. 2015;16(6):726\u2013731.2640616010.3171\/2015.6.PEDS15184"},{"issue":"11","key":"b35","series-title":"Expert Rev Med Devices","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1080\/17434440.2020.1837622","article-title":"Gravitational shunt valves in hydrocephalus to challenge the sequelae of over-drainage","volume":"17","author":"Gutowski P","year":"2020","unstructured":"Gutowski P, G\u00f6lz L, Rot S, Lemcke J, Thomale UW. Gravitational shunt valves in hydrocephalus to challenge the sequelae of over-drainage. Expert Rev Med Devices. 2020;17(11):1155\u20131168.3317649410.1080\/17434440.2020.1837622"},{"key":"b36","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"e642","DOI":"10.1016\/j.wneu.2017.10.044","article-title":"Intracranial Pressure-Guided Shunt Valve Adjustments with the Miethke Sensor Reservoir","volume":"109","author":"Antes S","year":"2018","unstructured":"Antes S, Stadie A, M\u00fcller S, Linsler S, Breuskin D, Oertel J. Intracranial Pressure-Guided Shunt Valve Adjustments with the Miethke Sensor Reservoir. World Neurosurg. 2018;109:e642\u2013e650.2905477610.1016\/j.wneu.2017.10.044"},{"key":"b37","first-page":"1087","article-title":"The sensor reservoir\u2014does it change management? Acta Neurochir. (Wien)","volume":"163","author":"Bjornson A","year":"2021","unstructured":"Bjornson A, Henderson D, Lawrence E, Ushewokunze S. The sensor reservoir\u2014does it change management? Acta Neurochir. (Wien).2021;163:1087\u20131095.33587185"},{"issue":"10","key":"b38","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"2487","DOI":"10.1007\/s00701-020-04421-7","article-title":"Single center experiences with telemetric intracranial pressure measurements in patients with CSF circulation disturbances","volume":"162","author":"Pennacchietti V","year":"2020","unstructured":"Pennacchietti V, Prinz V, Schaumann A, Finger T, Schulz M, Thomale UW. Single center experiences with telemetric intracranial pressure measurements in patients with CSF circulation disturbances. Acta Neurochir (Wien). 2020;162(10):2487\u20132497.10.1007\/s00701-020-04421-732495080"},{"issue":"5","key":"b39","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E4","DOI":"10.3171\/2014.8.FOCUS14436","article-title":"A comparison of lumboperitoneal and ventriculoperitoneal shunting for idiopathic intracranial hypertension: an analysis of economic impact and complications using the Nationwide Inpatient Sample","volume":"37","author":"Menger RP","year":"2014","unstructured":"Menger RP, Connor DE Jr, Thakur JD, Sonig A, Smith E, A comparison of lumboperitoneal and ventriculoperitoneal shunting for idiopathic intracranial hypertension: an analysis of economic impact and complications using the Nationwide Inpatient Sample. Neurosurg Focus. 2014;37(5):E4.2536343210.3171\/2014.8.FOCUS14436"},{"issue":"2","key":"b40","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1093\/neuros\/nyz080","article-title":"Lumboperitoneal and Ventriculoperitoneal Shunting for Idiopathic Intracranial Hypertension Demonstrate Comparable Failure and Complication Rates","volume":"86","author":"Azad TD","year":"2020","unstructured":"Azad TD, Zhang Y, Varshneya K, Veeravagu A, Ratliff JK, Li G. Lumboperitoneal and Ventriculoperitoneal Shunting for Idiopathic Intracranial Hypertension Demonstrate Comparable Failure and Complication Rates. Neurosurgery. 2020;86(2):272\u2013280.3093742810.1093\/neuros\/nyz080"},{"issue":"2","key":"b41","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1007\/s00701-020-04526-z","article-title":"Revision and complication rates in adult shunt surgery: a single-institution study","volume":"163","author":"Mansoor N","year":"2021","unstructured":"Mansoor N, Solheim O, Fredriksli OA, Gulati S. Revision and complication rates in adult shunt surgery: a single-institution study. Acta Neurochir (Wien). 2021;163(2):447\u2013454.10.1007\/s00701-020-04526-z33130985"},{"issue":"4","key":"b42","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"393","DOI":"10.3171\/2015.2.PEDS14387","article-title":"Ultrasound stylet for non-image-guided ventricular catheterization","volume":"16","author":"Coulson NK","year":"2015","unstructured":"Coulson NK, Chiarelli PA, Su DK, Chang JJ, MacConaghy B, Ultrasound stylet for non-image-guided ventricular catheterization. J Neurosurg Pediatr. 2015;16(4):393\u2013401.2614067010.3171\/2015.2.PEDS14387"},{"issue":"3","key":"b43","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E7","DOI":"10.3171\/2016.5.FOCUS1637","article-title":"Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis","volume":"41","author":"He M","year":"2016","unstructured":"He M, Ouyang L, Wang S, Zheng M, Liu A. Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis. Neurosurg Focus. 2016;41(3):E7.2758131910.3171\/2016.5.FOCUS1637"},{"issue":"3","key":"b44","series-title":"Semin Ophthalmol","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1080\/08820530802007333","article-title":"Laparoscopic-assisted lumboperitoneal shunt placement for idiopathic intracranial hypertension","volume":"23","author":"Hammers R","year":"2008","unstructured":"Hammers R, Prabhu VC, Sarker S, Jay WM. Laparoscopic-assisted lumboperitoneal shunt placement for idiopathic intracranial hypertension. Semin Ophthalmol. 2008;23(3):151\u2013155.1843254110.1080\/08820530802007333"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/136\/6\/article-p1790.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/136\/6\/article-p1790.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/136\/6\/article-p1790.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:07:35Z","timestamp":1794013655000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/136\/6\/article-p1790.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,1]]},"references-count":44,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2021.5.jns21821","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,1]]}}}