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Experience with the Subcutaneous Cerebrospinal-Fluid Reservoir — Preliminary Report of 60 Cases

List of authors.
  • Robert A. Ratcheson, M.D.,
  • and Ayub K. Ommaya, F.R.C.S.

Abstract

A subcutaneous cerebrospinal-fluid reservoir was used in 60 patients between 1962 and 1968. The total complication rate related to the reservoirs was 28 per cent. Major complications numbered six. Surgical revision, usually within the first three months after installation, was necessary in 25 per cent. After the first three months, complications were less frequent.

The reservoirs were used for the chemotherapy of neoplasia, cystic tumor drainage, ventricular drainage, special diagnostic studies and the sampling of cerebrospinal fluid. The reservoirs were particularly useful for intrathecal chemotherapy of resistant meningeal leukemia with perfusion technics, and for drainage of intracranial cysts. In selected cases, the advantages of the subcutaneous reservoir outweigh the morbidity incurred.

Funding and Disclosures

We are indebted to the many physicians who referred to us the patients in whom the reservoirs were installed, in particular Dr. John E. Bennett, head, Infectious Diseases Section, Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, who also provided valuable advice.

Author Affiliations

* From the Branch of Surgical Neurology, National Institute of Neurological Diseases and Blindness, National Institutes of Health, Public Health Service, United States Department of Health, Education, and Welfare, Bethesda (address reprint requests to Dr. Ommaya at the National Institute of Neurological Diseases and Blindness, Bethesda, Md. 20014).

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