IRRAflow active irrigation and drainage system: A glimpse into the future of cerebrospinal fluid shunts
Chronic hydrocephalus after subarachnoid hemorrhage may become inevitable, necessitating a permanent cerebrospinal fluid shunt. We report a 40-year-old woman with SAH and a CHESS score of 6. We implemented the IRRAflow active irrigation and drainage system which expedited hemorrhage clearance in 4 days compared to one or two weeks longer with standard external ventricular drains. This system reduced the inflammatory load and preserved the arachnoid granulations, which are responsible for CSF resorption. Further, expedited recanalization of the fourth ventricle prevented an exponential increase in intracranial pressure. Collectively, these factors prevented CSF shunt dependency.
Authors
- Richard W. Byrne (ORCID: https://orcid.org/0000-0001-9862-9373)
- Saif Salman (ORCID: https://orcid.org/0000-0002-7809-1745)
- Behnam Rezai Jahromi (ORCID: https://orcid.org/0000-0003-3937-2816)
- Rabih G. Tawk (ORCID: https://orcid.org/0000-0002-2695-0042)
- Daniel A. Tonetti (ORCID: https://orcid.org/0000-0002-9258-1820)
- Babak S. Jahromi (ORCID: https://orcid.org/0000-0001-5064-5278)
- Nicholas Brandmeir (ORCID: https://orcid.org/0000-0002-1854-5856)
- William D. Freeman (ORCID: https://orcid.org/0000-0003-2326-0633)
- Krishnan Ravindran (ORCID: https://orcid.org/0000-0003-0349-1231)
Institutions
- Northwestern University (US)
- West Virginia University (US)
- University of Helsinki (FI)
- Cooper University Hospital (US)
- Jacksonville College (US)
- WinnMed (US)
- Blanchette Rockefeller Neurosciences Institute (US)
- Mayo Clinic in Florida (US)
- Neurological Surgery (US)
Publication Details
- Journal
- Brain Hemorrhages
- Published
- 2025-11-05
- DOI
- https://doi.org/10.1016/j.hest.2025.10.002
- Primary Topic
- Cerebrospinal fluid and hydrocephalus
- Type
- article
- Field-Weighted Citation Impact
- 0.00