A review of the Johns Hopkins Hospital surgical records from 1896 to 1912 revealed a case from 1908 wherein Dr. Harvey Cushing attempted to treat hydrocephalus in a 4-month-old infant by constructing a shunt for which he used a venous segment harvested from the patient's father. Prior to this procedure, surgeons used shunts constructed from various often highly immunogenic materials. In addition to addressing the limitations of these materials, Cushing's technique allowed the inclusion of valves within the shunt, preventing the retrograde flow of CSF. Despite the success of this procedure in canine models, the child's postoperative death prevented an assessment of its success in a human. It is possible that Cushing's approach would meet with more success today, given the modern benefits of human leukocyte antigen tissue typing and immunosuppressant agents.
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