ABSTRACT
OBJECT: The management of hydrocephalus can be challenging because of the unique cerebrospinal fluid (CSF) dynamics in each patient. Various shunt systems have been developed for the treatment of hydrocephalus. One of the main issues surrounding these systems is overshunting due to siphoning. In this paper the authors discuss the pathophysiology of CSF siphoning as well as the various devices used to treat this problem. The pros and cons of each device are discussed, as are the key differences among them. Future concepts are also introduced with an emphasis on upcoming device designs. METHODS: The authors performed a literature review of articles addressing CSF dynamics, shunting, and regulatory devices. The literature consisted of original research articles, company literature on each device, and patent information. A number of siphon regulatory devices have been developed over the past two decades. Each device has a distinct design, requiring specific techniques of implantation for optimal function. CONCLUSIONS: For the past two decades, a variety of siphon regulatory devices have been used to help deal with CSF siphoning. With the increasing mobility of the population, every neurosurgeon will be seeing patients with older and newer devices. Familiarity with the various devices will assist in the evaluation and care of these patients.
