INDICATIONS OF VP SHUNT //CSF LEAK REPAIRS

Based on the highlighted text in the image, the indications for ventriculoperitoneal shunt placement in the context of CSF leak repair include:
1. Spontaneous CSF Leak – Cases where cerebrospinal fluid leakage occurs without trauma or surgery.
2. High-Volume CSF Leaks – Persistent or excessive leakage that increases the risk of recurrence.
3. Elevated Opening Pressure more 20 cm H₂O – Suggesting idiopathic intracranial hypertension (IIH) or increased CSF pressure as a contributing factor.
4. Obesity BMI more than 30 kg/m²– A known risk factor for spontaneous CSF leaks and recurrence.
5. Preoperative Imaging Showing Additional Cranial Base Defects – Including contralateral tegmen or anterior cranial base defects, indicating a predisposition to further leaks.
6. Empty Sella Syndrome – A radiological finding associated with increased intracranial pressure and CSF leaks.
7. Conditions Leading to Arachnoid Granulation Inflammation and CSF Absorption Impairment – Such as meningitis, intracranial hemorrhage, or significant closed-head injury.

These factors suggest a higher risk of recurrence of CSF leaks, making VP shunt placement a consideration to reduce CSF pressure and prevent further complications

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