[Extracorporeal ventriculoatrial shunt with the use of one-way ball valve].

We developed a simple system of an "extracorporeal" ventriculoatrial (VA) shunt using a one-way ball valve (Acty valve II, Kaneka Medix) to release the patient from postoperative constraint during the ventricular drainage. The system is constructed in such a way that the ventricular drainage tube is connected to the central venous catheter via a one-way valve. The CSF is regulated by using the valve and is diverted into the systemic circulation as in the conventional ventriculoatrial shunt.

Is sedation necessary for demented patients under infiltration anesthesia?

Background: Sedation for intraoperative patients under infiltration anesthesia is often used, however, disadvantages of sedation for demented patients may sometimes exceed its advantages because some of the demented patients are already apathetic about their surroundings. The authors prospectively investigated whether sedation for alert or demented patients receiving surgery under infiltration anesthesia is useful and safe for intraoperative management.

Methods: Sixty patients undergoing irrigation and drainage of chronic subdural hematoma under infiltration anesthesia were divided into four groups.

[Effects of changes in head and neck position on a tracheal tube cuff].

Thirteen patients were intubated with cuffed reinforced spiral tracheal tubes. Intracuff pressure and volume were measured as the position of the head and neck was altered. No significant changes in intracuff pressure and volume were observed with lateral rotation of the head.

A case of shock subsequent to treatment of intracranial hypertension by mannitol injection combined with hyperventilation.

This report describes a sudden decrease in blood pressure after conservative treatment of acute intracranial hypertension. A 63-year-old woman with acute hydrocephalus after undergoing clipping of an aneurysm of the right supracerebellar artery developed increased intracranial pressure, necessitating surgical management. On the operating table, the patient developed Cushing's reflex.