Indications for Surgery
- Symptomatic hydrocephalus: Dandy-Walker malformations with significant hydrocephalus require surgical intervention. Those without significant hydrocephalus may be followed conservatively.
Preoperative Orders
- Antibiotics: The authors administer vancomycin prior to shunt procedures.
- Clamp time for CSF drain: Clamping the drain several hours prior to the procedure may help. ICP should be monitored when the drain is clamped, and the patient should be monitored for symptoms.
- Surgical site scrub: A sterile scrub is performed prior to the procedure.
Anesthetic Considerations
- ICP precautions: Patients should be considered to have elevated ICP.
Devices to Be Implanted
- Shunt materials: Ventriculoperitoneal shunt or ventriculostomy as indicated.
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