{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:33:53Z","timestamp":1753893233182,"version":"3.41.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Conventional corticospinal fluid (CSF) diversion surgery for idiopathic normal pressure hydrocephalus (iNPH) includes ventriculoperitoneal shunt and ventriculoatrial shunt. Ventriculosternal (VS) shunt may be considered if both the abdominal cavity and atrium are not feasible.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A 76-year-old woman was admitted to our hospital with gait disturbance and urinary incontinence for 2 years, and the condition aggravated in the last 1 month. Based on clinical assessment and imaging findings, the patient was diagnosed with iNPH, with surgical indications. She was on peritoneal dialysis for chronic renal failure, and a cardiac Doppler echocardiogram showed enlargement of the left atrium and decreased diastolic function of the left ventricle. Due to these conditions, we chose the sternum as the vessel for CSF absorption and performed VS shunt.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> No swelling, exudation, and effusion were found in the suprasternal fossa. Gait disturbance and urinary incontinence improved significantly immediately and 1 week after surgery, respectively. No shunt-related complication was reported at 16 months follow-up.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> This case demonstrated VS shunting as a feasible and alternative for the management of hydrocephalus.<\/jats:p>","DOI":"10.3389\/fsurg.2021.607417","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T11:38:21Z","timestamp":1629718701000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Ventriculosternal Shunt for the Treatment of Idiopathic Normal Pressure Hydrocephalus: A Case Report"],"prefix":"10.3389","volume":"8","author":[{"given":"Xinxia","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul Malik","family":"Popal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhoule","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengwei","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingquan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongjie","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianmin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anwen","family":"Shao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junming","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1227\/01.NEU.0000168188.25559.0E","article-title":"Development of guidelines for idiopathic normal-pressure hydrocephalus: introduction","volume":"57","author":"Marmarou","year":"2005","journal-title":"Neurosurgery."},{"key":"B2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.clineuro.2016.02.013","article-title":"Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus","volume":"143","author":"Liu","year":"2016","journal-title":"Clin Neurol Neurosurg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/j.jocn.2008.12.007","article-title":"A prospective study of ventriculo-peritoneal shunting for idiopathic normal pressure hydrocephalus","volume":"16","author":"Razay","year":"2009","journal-title":"J Clin Neurosci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1227\/NEU.0000000000000861","volume":"11","year":"2015","journal-title":"Neurosurgery"},{"key":"B5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/10903120090941461","article-title":"A new system for sternal intraosseous infusion in adults","volume":"4","author":"Macnab","year":"2000","journal-title":"Prehosp Emerg Care."},{"key":"B6","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1227\/NEU.0b013e3181ffa21c","article-title":"A novel method for cerebrospinal fluid diversion: a cadaveric and animal study","volume":"60","author":"Tubbs","year":"2011","journal-title":"Neurosurgery"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1136\/jnnp.48.11.1091","article-title":"Positron emission tomography with [18F]fluorodeoxyglucose differentiates normal pressure hydrocephalus from Alzheimer-type dementia","volume":"48","author":"Jagust","year":"1985","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B8","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.jocn.2016.09.004","article-title":"The predictive value of DESH for shunt responsiveness in idiopathic normal pressure hydrocephalus","volume":"34","author":"Craven","year":"2016","journal-title":"J Clin Neurosci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1159\/000111149","article-title":"Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus","volume":"25","author":"Kubo","year":"2008","journal-title":"Dement Geriatr Cogn Disord."},{"key":"B10","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. 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