Fig. 7.

Representative optimal and sub-optimal shunt placements in hydrocephalic pigs after 20–30 days of treatment. A–F′. T2-weighted sagittal, axial, and coronal MRI images illustrating optimal (case 13, A–C′) and sub-optimal (case 10 D–F′) shunt placement. Pre- and post-shunt images were taken from the same two pigs. Shunting reduced (but did not eliminate) the flow void in the third ventricle and decreased the size of all ventricles when optimally placed, but not to control levels. In the optimal case, the arrows indicate the catheter (A′–C′) inside of the right lateral ventricle. In the sub-optimal case (D′–F′), arrows indicate the catheter and asterisks indicate the catheter tip (D′–F′). G–L Representative gross morphological features of shunt-treated hydrocephalic pig brains (Case 13 for optimal placement, and Case 12 for sub-optimal case). In sub-optimal case, the catheter (arrow in J) was located along the dorsolateral wall of the lateral ventricle with some contact with the choroid plexus. In all cases, H and I, K and L columns contain coronal views from the same case as the midsagittal sections in G and J, respectively. In the optimally placed shunt case, the ventricles were reduced in size but not in the sub-optimal placement. In J and L, the ventricular catheter contacted the choroid plexus (CP) but retained some open drainage holes, and the catheter track (black arrow in J and L) contacted the CP. M Graph showing the total ventricular volumes in mm³ before (pre) and after (post) 20–30 days of shunt treatment (Sub-optimal cases are case 10 -blue- and case 12-red-; optimal cases are 13-green- and 17 –purple-). N–P Ventricular volume reconstructions of a representative optimal shunt placement before and after shunt treatment in the same cases used for the MRI (case 13). Note the reduction of the total ventricular volume after 30 days of shunt treatment. Abbreviations: a, anterior, l, left, p, posterior, r, right. Scale bars = 10 mm for all the MRI scan and gross anatomy panels