JPH03141924A - Ventricle shunt also capable of measuring cranium inner pressure - Google Patents

Abstract

PURPOSE:To facilitate handling an embedded matter, etc., in vivo by adding a simple means to a ventricle shunt. CONSTITUTION:A cranium inner pressure measuring means introduces marrow liquid through a ventricle catheter 2 to a cranium inner pressure measuring reservoir 11 embedded under a head skin 16 over a cranium bone 17 with an embedded matter A embedded in a predetermined position of a body of a patient and starts measuring by turning on a pressure detecting means B. By applying detection end 30 of the pressure detecting means B to an upper dome 11a through the head skin 16, measuring of pressure P is started. A pushing-in depth L and the detected pressure P have characteristics with two inflection points BP1, BP2, and there is only a small width change of the detected pressure P between the inflection points BP1-BP2. A cranium inner pressure can thus be detected indirectly from the outside of the head skin 16.

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to a ventricular shunt device for measuring intracranial pressure,
In particular, the present invention relates to an intracranial pressure measuring and ventricular shunt device capable of measuring intracranial pressure in patients with hydrocephalus or the like. The ventricular shunt in this device is a ventricle-peritoneal shunt or a ventricle-peritoneal shunt that is surgically implanted into the body of a patient suffering from hydrocephalus, etc.
It functions as an atrial shunt.

[Prior Art] Generally, in neurosurgical diseases accompanied by increased intracranial pressure, accurate measurement of intracranial pressure is necessary to elucidate the pathological picture.

Various methods have been proposed to measure intracranial pressure, including Sar! ,Nturol,,vol II,
In April 1979, a "remote pressure sensor for ventricular shunt system" was proposed.

This remote pressure sensor for ventricular shunt system is provided with a ventricular shunt 50 and a pressure detection device 60, as shown in FIGS.
is a tubular ventricular catheter 51 inserted into the ventricle.
and a shunt main body (relay chamber) 52 connected to this ventricular catheter 51 and composed of a reservoir and a pump chamber,
The shunt main body 52 is connected to a tubular peritoneal catheter or an atrial catheter 53 that is inserted into the abdominal cavity or atrium.

The shunt main body 52 is buried on the skull 17 under the scalp 16, and the shunt main body 52 includes a miter valve or the like that can be pushed open by the pressure of cerebrospinal fluid, which is fluid discharged from the ventricles. A relief valve 54 is provided.

Furthermore, the shunt main body 52 includes a flexible diaphragm 55 formed in the upper part of the flow path and capable of expanding upward in response to the pressure of the cerebrospinal fluid flowing in the flow path, and a flexible diaphragm 55 formed in the lower part of the flow path. A diaphragm stopper 56 is provided to face the flexible diaphragm 55, and a pressure detection device 6 is provided in the flow path of the shunt body 52.
An embedded pressure sensor 57 forming a part of the diaphragm 0 is inserted, and this embedded pressure sensor 57 is embedded in the shunt body 52 forming the diaphragm stopper 56 and has a resonant circuit such as a coil. It is composed of a tuning circuit 58 and a tuning element 59 attached to the flow path side of the flexible diaphragm 55 and changing the resonance frequency of the tuning circuit 58 according to the distance between the tuning circuit 58 and the tuning circuit 58.

The pressure detection device 60 is comprised of the above-mentioned embedded pressure sensor 57 embedded within the patient's body, and the following members provided outside the patient's body.

That is, outside the body, there is an antenna 61 that sends electromagnetic waves to the pressure sensor 57 in order to detect the resonant frequency in the pressure sensor 57, and an electronic device 62 that receives a change in the signal sent to the antenna 61 and indicates that it is at the resonant frequency. In addition, a non-metallic diaphragm 55 is inflated by air pressure to bring the tuning element 59 of the implantable pressure sensor 57 closer to the tuning circuit 58 by pressing the above-mentioned flexible diaphragm 55 through the scalp 16. A pressurizing body 63 is inserted between the scalp I6 and the antenna 61, and a compressed air supply device 6 supplies compressed air to the pressurizing body 63.
4, and a pressure gauge 65 for detecting the pressure of the compressed air supplied from the compressed air supply device 64.

In such a conventional example, intracranial pressure is measured by the following procedure.

<1> The electronic device 62 receives the signal from the antenna 61 by placing the antenna 61 at the detection position, pressing the diaphragm 55 with a finger through the scalp 16, and bringing the tuning circuit 58 and tuning element 59 close together. Calibrate.

<2> In the <l> position, release your finger and release the diaphragm 55.
bulges outward, the tuning circuit 58 and the tuning element 59 are separated, and the signal from the antenna 61 causes the electronic device 62 to
Check that the display moves away from the calibration area.

<3> Insert the pressurizing body 63 between the scalp 16 and the antenna 61 and apply pressure until the display on the electronic device 62 is in the calibration range, and the pressure measured by the pressure gauge 65 at this time is the intracranial pressure. shall be.

[Problem that the invention seeks to solve]

However, in such conventional intracranial pressure measuring means, a resonant circuit consisting of a tuned circuit 58 and a tuned element 59 must be built into the body, and a part that responds to electromagnetic waves etc. is buried inside the body. There are problems in that it interferes with the formation of tomographic images by CT scanners, nuclear magnetic resonance scanners, etc., and the overall structure is complicated, making it difficult to calibrate accurately.

The present invention aims to solve these problems, and by adding a simple means to the ventricular shunt, the present invention provides a cranial ventricular shunt that makes it easier to handle objects implanted in the body. The purpose of the present invention is to provide a ventricular shunt device that can also be used to measure internal pressure.

[Means for solving problems]

Therefore, the ventricular shunt device for intracranial pressure measurement of the present invention includes a ventricular catheter whose tip is inserted into the ventricle of the brain to drain cerebrospinal fluid from the same ventricle, and a ventricular catheter whose tip is inserted into the abdominal cavity or atrium. a peritoneal catheter or an atrial catheter capable of delivering the cerebrospinal fluid to the same peritoneal cavity or atrium; and a proximal end of the ventricular catheter and a proximal end of the peritoneal catheter or atrial catheter respectively connected to The shunt main body is provided with a check valve capable of preventing backflow of cerebrospinal fluid from the above-mentioned peritoneal catheter or atrial catheter to the above-mentioned ventricular catheter, and the above-mentioned shunt main body is provided with a shunt main body that communicates with the above-mentioned peritoneal catheter from the above-mentioned ventricular catheter. or a cutoff valve mechanism that can block the flow of cerebrospinal fluid to the atrial catheter, and a flow path that is inserted into the ventricular catheter side than the cutoff valve mechanism, and is implanted under the scalp to guide the cerebrospinal fluid. and a reservoir for measuring intracranial pressure placed on the skull, the reservoir being formed at the upper part of the reservoir so as to protrude outward, and being expanded by the pressure of the cerebrospinal fluid and deflecting in response to pressure from an external force. A flexible convex curved dome for measuring intracranial pressure is provided, and a tip is formed so as to be substantially flush with a guide portion that can be brought into contact with the convex curved dome from the outside through the scalp and the tip of the guide portion. The present invention is characterized by comprising a detection end consisting of a pressure receiving part of the detection end, a pressure sensor connected to the pressure receiving part of the detection end, and an external device that receives and displays or records a detection signal from the pressure sensor.

[For production]

In the above-mentioned intracranial pressure measuring and ventricular shunt device of the present invention, cerebrospinal fluid is guided from the ventricle to the intracranial pressure measuring reservoir through the ventricular catheter, and the curved dome of the reservoir is expanded by the pressure of this cerebrospinal fluid. The guide part and the pressure receiving part at the detection end of the pressure sensor are brought into contact with the curved dome through the scalp, and the pressure sensor detects the pressure according to the pushing state of the detection end, and the external device displays or records it, From the indentation depth and detected pressure, these inflection points (i.e., the point where the detected pressure changes depending on the indentation depth)
and the detected pressure in the vicinity thereof is the intracranial pressure.

Furthermore, in the above-mentioned intracranial pressure measuring and ventricular shunt device of the present invention, by opening its isolation valve mechanism, excess cerebrospinal fluid in the ventricle flows out to the peritoneal cavity or atrium, similar to a normal ventricular shunt. An action is taken to make it happen.

〔Example〕

Hereinafter, embodiments of the present invention will be explained with reference to the drawings.
1 to 6 are shown to explain the intracranial pressure measuring means in the intracranial pressure measuring and ventricular shunt device of the present invention.
The figure is a 70-chart to explain the measurement procedure, Figure 3 0) to (d) are schematic side views showing the measurement procedure, Figure 4 is a graph to explain the action, Figures 5 and 6 are schematic perspective views and side views for explaining the measurement principle, and Figures 7 to 14 show a ventricular shunt device for intracranial pressure measurement as a first embodiment of the present invention. , Fig. 7 is a cross-sectional view showing the ventricular shunt in this device (cross-sectional view taken along arrows - ■ in Fig. 8), and Fig. 8 is a schematic longitudinal cross-sectional view showing its measurement state (the ventricular shunt is shown in Fig. 8). ■ in figure 7
9 is a sectional view taken along the ff-IX arrow in FIG. 7, FIG. 1O is a sectional view taken along the X-X arrow in FIG. XI-IIX arrow sectional view 1+ (b)
~(d) are all schematic diagrams for explaining the action at the time of burial, and Figure 12 is a sectional view taken along the ■-■ arrow in Figure 7.
13 is a sectional view taken along the line xm-xm in FIG. 7; FIG. 14 is a plan view showing an enlarged section XIV in FIG. 7;
．． FIG. 16 is a schematic longitudinal sectional view and a schematic plan view of a ventricular shunt in a ventricular shunt device for intracranial pressure measurement as a second embodiment of the present invention.
7. The same reference numerals as in Figure 18 indicate almost the same things.

As shown in FIGS. 1 to 6, the intracranial pressure measuring means in the intracranial pressure measuring and ventricular shunt device of the present invention includes an implant A that is buried inside the patient's body, and an implant A that is placed outside the patient's body.
It is comprised of a pressure detection device B that can come into contact with a reservoir 11 for measuring intracranial pressure in an implanted object through the scalp 16.

The implant A includes a tubular ventricular catheter 2 into which the distal end 2b of a patient's ventricle 194 can be inserted to drain cerebrospinal fluid from the ventricle 19, and a reservoir 11 connected to the catheter 2.
The implant main body 22 is made of a soft wall made of silicone resin or the like and is fixed on the skull 17 under the scalp 16. Above the reservoir 11, there is a flexible thin film for intracranial pressure measurement. A convex curved dome 111 is formed.

The pressure detection device tB includes a pressure detector 23, an amplifier 25 that receives and amplifies a pressure detection signal from the pressure sensor 23s of the pressure detector 23 via a lead wire 24, and the amplifier 2.
It is comprised of a recorder 27 such as a printer for receiving and recording the amplified signal from 5 via a lead wire 26, and a display device 28 such as a CRT for displaying.

The pressure detector 23 is configured as a transcutaneous cerebral pressure sensor, and includes a case 231, an outer cylinder 23b of a predetermined length connected to the detection end side of the case 231, and an outer cylinder 23b connected to the back side of the case 231. The presser plate 23c, the columnar pressure receiving part 23d slidably inserted into the outer cylinder 23b, and the lead wire 24 are connected to the pressure receiving part 23d to convert the pressure from the pressure receiving part 23d into an electric signal. A diffusion type semiconductor pressure sensor (or load sensor) 23c having silicon molded on the surface of the reservoir to be output through the case 231, a hard spring 231 that applies a biasing force to the pressure sensor 23e in the case 231, and the pressure sensor 23e are positioned. It consists of a zero adjuster 23g.

In addition, the code|symbol 20 in a figure shows a brain, and 21 shows a dura mater.

Since the intracranial pressure measuring means in the intracranial pressure measuring and ventricular shunt device of the present invention is constructed as described above, the intracranial pressure can be measured as shown in FIGS. can be measured.

(1) 16 below the scalp and the skull! The cerebrospinal fluid is guided through the ventricular catheter 2 to the intracranial pressure measurement reservoir 11 buried above the cerebrospinal fluid, and the upper dome lli of the reservoir 11 is expanded to protrude outward due to the pressure of the cerebrospinal fluid. Step 12).

(2) Turn on pressure detection device B and start measurement [
Sensor depth LA reference J0 at time tA in FIGS. 3(1) and 4 At this time, the detection end 30 is
They are also separated and are in a non-contact state.

Therefore, in this state, no pressure is applied to the dome Ila from the outside.

(3) Connect the detection end 30 of the pressure detection device B to the upper dome 1
11 through the scalp 16 [see sensor depth at time t3 in FIG. 3(b) and FIG. 4], measurement of the pressure P is started (step a3).

(4) Next, push in the detection end 30 until the center of the upper surface of the upper dome opening 1 becomes flat [see sensor depth Lc at time 1c in FIG. 3(C) and FIG. 4].

In this state, the tip surface of the pressure receiving part 23d and the guide part 23
Curved dome 11 through the tip surface of b and the scalp 16! In a state where the upper surface of the co-pi is a quasi-plane (co-pi port C), an inflection (hereinafter, this inflection point is referred to as rBP +J) occurs in the relationship between the indentation depth L and the detected pressure P.

(5) Further, the pushing is continued until the upper surface of the upper dome Ill is crushed [see @ sensor depth L0 at time +D in FIG. 3(d) and FIG. 4].

In this state, the distal end surface of the pressure receiving part 23d is pushed up relative to the guide part 23b by the curved dome fig through the scalp 16 and begins to sink into the guide part 23b.
An inflection (hereinafter, this inflection point is referred to as rBP, J) occurs in the relationship between the indentation depth L and the detected pressure P.

(6) The pressure detected by the pressure detection device B during this pushing process is measured by recording it with the recorder 27 or displaying it on the display device 28, and even if the pushing depth L of the detection end 30 is slightly changed, the detected pressure The section where P does not change (inflection point B
P, ~BP,) is detected, and the detected pressure P in this section is
is the intracranial pressure. (Step 14) That is, the indentation depth L and the detected pressure P have two inflection points BP, BP2, and between the inflection points BP and BP, the detected pressure P is The range of change is small.

The principle of transcutaneous intracranial pressure measurement performed in this manner is based on the premise that the following conditions hold, and the measurement is performed on the following measurement object.

First, as shown in FIG. 1, the conditions are that intracranial pressure is derived directly below the scalp 16, and that a pressure equal to the intracranial pressure exists in a "soft" dome lla of radius r.

In this case, the object to be measured is the pressure within the implant body 22 (ventricular shunt body 1) embedded under the scalp 16, and this pressure is indirectly measured from outside the scalp 16. At this time, it is assumed that there is almost no change in intracranial pressure even if the scalp 16 and reservoir 11 are lightly compressed.

At this time, the following measurement principle is derived from Laplace's theorem.

As shown in FIG. 5, the scalp 16 and the implant body 22 (
When considering the dome opening 1 of the ventricular shunt body 1) as part of a sphere with a radius of ``, the sphere has internal pressure (brain pressure) Pi, external pressure (usually atmospheric pressure) Pa, scalp 16 and Laplace's theorem is established between this and the tension T of the dome l1g of the object body 22.

That is, the following relationship holds true.

Pi-Po= 2T/r ・' ” (1) Here, when measuring the internal pressure Pi from outside the dome mouth 1, Pi=
It suffices if a condition such that Po is established under the (+) expression.

Based on Laplace's theorem, the following measurement principle is established.

Dome 11 now! The outside of the plate 29 is as shown in FIG.
Try applying pressure. The upper surface of the dome IIs is made flat by the plate 29. Letting the area of the planar portion of this plate 29 be D, in the area of D, based on Laplace's theorem mentioned above, it corresponds to `` becoming infinite.

That is, if ``is ■, then the right side of the equation (+) becomes 0, and in this case, Pi=Po holds.From this, when the dome 11! and the scalp 16 are compressed with an appropriate external pressure,
It can be seen that the external pressure applied to the planar portion is equal to the internal pressure.

However, in actual measurements, it is necessary to pay attention to the following points in order to accurately compress only the necessary portions of the dome 111.

■ Pressing the dome lli flat ■ Detecting external pressure only in the above area ■ Dome I more than necessary
Do not destroy Is If these conditions are satisfied, actual measurements can be carried out.

As shown in FIGS. 7 to 14, the ventricular shunt device for intracranial pressure measurement as the third embodiment of the present invention is a ventricular shunt device that is implanted in the patient's body. Functional ventricular shunt A' for intracranial pressure measurement
is used, and the pressure detection device B is the same as that described above. The ventricular shunt A' for intracranial pressure measurement also has the function of a flow rate switching type ventricular shunt, and can drain cerebrospinal fluid from the ventricle 19 of the patient by inserting its tip 2b into the ventricle 19 of the patient. A tubular ventricular catheter 2, a peritoneal catheter or an atrial catheter (hereinafter referred to as "peritoneal catheter") 3 whose tip can be inserted into the peritoneal cavity or atrium to send out the cerebrospinal fluid to the peritoneal cavity or atrium, and a brain. The proximal end 21 of the ventricular catheter 2 and the proximal end 31 of the peritoneal catheter 3
The shunt main body (relay chamber) 1 is made of a soft wall made of silicone resin or the like and has a main passage 10 that is connected to the catheters 2.3 and communicates each catheter 2.3 with each other.

In addition, the shunt body 1, the ventricular catheter 2, and the peritoneal catheter 3 are provided with a check valve 4 that can prevent backflow of cerebrospinal fluid from the peritoneal catheter 3 to the ventricular catheter 2. In this embodiment, the function of the valve 4 is also shared by slit-type relief valves 6 and 7 as flow rate adjusting sections of a flow rate switching mechanism 5, which will be described later.

These slit type relief valves 6.7, as shown in FIG. 14, have valve seats 8! , 9 are formed integrally with each other to constitute a relief valve equipped member 33, and this relief valve equipped member 33 is sandwiched between the upper part 1A and the lower part IB of the shunt body 1 and is bonded to the shunt body 1. It has become.

That is, the shunt main body 1 is separated into an upper part IA and a lower part IB at the hatched portion in FIG. 7, and is assembled by adhering them to each other.

The shunt body 1 is attached to the skull 1 under the scalp 16 by suturing the suture or the like passing through the suture through hole 15 to the scalp 16.
a main passage 10 fixed on the ventricular catheter 7 and connected to the above-mentioned ventricular catheter 2 and peritoneal catheter 3; and a small chamber-shaped glue reservoir 11 formed on the ventricular catheter 2 side of the main passage 1O.
, a small chamber 12 formed on the peritoneal catheter 3 side of the main passage 10 , and a first chamber 12 that connects the branch part 101 and the small chamber 12 in the main passage 10 downstream of the reservoir 11 in parallel with each other.
The flow path 3 and the second flow path 14 are provided.

In the first flow path 13, as shown in FIG.
A slit 6 of a predetermined depth DI that can adjust the flow rate in the communicating state of the flow path 13 to a predetermined flow rate Q1! The first formed
A slit-type relief valve 6 as a flow rate adjustment part of the shunt body l and a pole-type on-off valve 8 as an on-off valve of @l that can shut off the flow path 13 of this wcl by receiving a driving force from the outside of the shunt body l are interposed. It is inserted.

The pole type on-off valve 8 includes a circular valve seat 8& formed on the wall surface of the shunt main body l, a valve chamber 8b formed in a first flow path 13 on the upstream side opposite to the circular valve seat 81, The soft upper wall 11 and the soft front wall 1b of the valve chamber 8b are sealed in the chamber 8b.
A movable spherical valve body 8c that can be moved by receiving a driving force from a finger 18 or the like from the outside of the scalp 16, and a movable spherical valve body 8c that can be moved by seating the valve body 8c on the valve seat 8! The valve body 8c is seated on a closed position holding circular seat (recess) 8d which is sandwiched between the soft upper wall 1a and closes the on-off valve 8 and blocks the first flow path 13 in a position aligned with the above. According to the same valve body 8c
and a circular seat (recess) 8e for holding the open position, which is held between the soft upper wall 11 at a position apart from the valve seat 8a to open the on-off valve 8 and communicate the first flow path 13. .

In the second flow path 14, as shown in FIG.
A predetermined depth o xc that can adjust the flow rate in the communication state of the flow path 14 to a predetermined flow rate Q, (here, -1/2QI)
A slit-type relief valve 7 as a second flow rate adjusting section in which a slit 71 of < DI) is formed, and a shunt body l.
A pole type on-off valve 9 serving as a second on-off valve that can shut off the second flow path 14 by receiving a driving force from the outside is inserted.

The pole type on-off valve 9 has a circular valve seat 91 formed on the wall surface of the shunt body l, and the same circular valve seat 9! A valve chamber 9b formed in the second flow path 14 on the upstream side facing the valve chamber 9b, and a soft upper wall 11 and a soft front wall 1c of the valve chamber 9b sealed in the valve chamber 9b.
A movable spherical valve body 9c that can move in response to a driving force from a finger 18 or the like from the outside of the scalp 16 is held between the valve body 1a and the valve body 1a by seating the valve body 9c, thereby closing the on-off valve 9. A closed position retaining circular seat (recess) 9d that blocks the soft upper wall passage 14 at a position where the second flow 9c is directly aligned with the valve seat 9, and a closed position holding circular seat (concave portion) 9d that closes the valve body 9c by seating the valve body 9c.
and a circular seat (recess) 9e for holding the open position, which is held between the valve seat 9 and the soft upper wall 11 at a position apart from the valve seat 9, and opens the on-off valve 9 and communicates the second flow path 14. It is set as II in substantially the same way as the above-mentioned Paul type on-off valve 8.

The first relief valve 6 has a larger regulated flow rate than the second relief valve 7, and in this embodiment, each relief valve 6.
7 is constructed as a single-slit type check valve, but these may be changed to a cross-slit type, a spring-equipped type, a membrane type, etc.

The movable spherical valve bodies 8c, 9c may be made of plastic or metal, but may also be made of a metal ball coated with silicone resin. In the case of a plastic movable spherical valve body, the movable spherical valve body 8c is taken from an X-ray photograph as in the case of a metal movable valve body.

It is desirable to mix a contrast agent into the plastic material so that the position of the object 9c can be confirmed.

The flow rate switching mechanism 5 controls the predetermined flow rate Q as described above.

A first flow rate switching section 51 includes a slit type relief valve 6 and a pole type on-off valve 8 inserted in the flow path 13 to control the flow of the predetermined flow rate Qz(-1/4Q+). It is composed of a flow rate switching section 5b of a wc2 equipped with a slit type relief valve 7 inserted in a flow path 14 and a pole type on-off valve 9 to control the flow, and these on-off valves 8
．． The moving direction of the valve bodies 8c and 9e at 9 is F , , F ,
are configured to be parallel to each other and parallel to the center lines C and L of the shunt body l.

Furthermore, the valve chambers 8 b and 9 b of the pole type on-off valve 8.9
The orientation of the valve seats 8*, 9s facing the valve bodies 8c, 9
It is set to tilt toward the center from the moving direction F, , F of c.

That is, the first flow path 13 is connected in a straight line between the center of the small chamber 12 and the center position of the circular seats 8 d and 9 d.
, 14 are formed, and a valve body 8c is formed from the circular seats 8d and 9d.
, 9c in the direction opposite to the circular seats 8e, 9e, the soft rear wall 1d, which forms the outer wall of the shunt body l, is immediately seen.
Ie is placed.

Moreover, the first and second flow rate switching parts 5s and 5b have a function as a shutoff valve mechanism V by being closed simultaneously.

Since the ventricular shunt device for intracranial pressure measurement as the first embodiment of the present invention is constructed as described above, with the ventricular shunt A'' for intracranial pressure measurement buried in a predetermined position,
Intracranial pressure can be measured by performing the following procedure (0) before the procedures indicated by (+) to (6) described in FIGS. 2 to 4 above.

(0) Close the shutoff valve mechanism V that can block the flow of cerebrospinal fluid from the ventricular catheter 2 to the peritoneal catheter 3 in the shunt body 1, and check the flow of cerebrospinal fluid].

In this case, the shutoff valve mechanism V is operated by simultaneously closing the first and second flow rate switching sections 5a and 5b.

The intracranial pressure measurement/ventricular shunt device of this embodiment has the function of measuring the intracranial pressure described above, as well as the function of switching the flow rate as described below.

As shown in FIG. 11(d), a movable spherical valve body 8c.

9C are seated on the open position holding seats 8e and 9e, respectively, the cerebrospinal fluid flowing from the patient's ventricle 19 through the ventricular catheter 2 into the reservoir If flows through the main passage 10 and the first and wc2. It passes through the flow paths 13 and 14, enters the valve chambers 8b and 9b, passes through the two open valves 8 and 9, and enters the upstream side of the relief valves 6 and 7.

At this time, if the difference between the pressure of the cerebrospinal fluid upstream of the relief valves 6 and 7 and the pressure of the cerebrospinal fluid downstream of the relief valves 6 and 7 is equal to or greater than a predetermined value, the relief valve 6
．． 7 becomes open, cerebrospinal fluid flows into the small chamber 12, and the cerebrospinal fluid in this small chamber 12 is further 1+*l -+--;I
+Su L12 Pu Yumuha ^-2 Flowing into Seshan.

In this way, the cerebrospinal fluid from the ventricles flows at a maximum flow rate as the sum of the regulated flow rates of the two relief valves 6.7 (Q l + Q ff1).

Next, if you want the flow rate to be medium Ql, as shown by the chain line in FIG. All that is required is to seat the spherical valve body 9c on the circular seat 9d and close the second on-off valve 9, thereby allowing the cerebrospinal fluid to flow only through the first relief valve 6, which has a relatively large regulated flow rate. can.

In addition, when it is desired to make the flow rate even smaller Q2, as shown by the solid line in FIG. 9c is seated on the circular seat 9e, and the second on-off valve 9 is opened.
, and the cerebrospinal fluid can flow only through the second relief valve 7, which has a relatively small regulated flow rate.

As mentioned above, in this embodiment, the first relief valve 6 and the second relief valve
Since the relief valves 7 have mutually different regulated flow rates, the two relief valves 6 and 7 perform three-stage flow rate switching and shutoff, but both relief valves 6 and 7 have the same regulated flow rate. Even in the case of having a flow rate, the flow rate can be switched in two stages: when the flow rate is made to flow only to one side, and when it is made to flow to both sides.

When it is desired to stop the outflow of cerebrospinal fluid via this ventricular shunt, the movable spherical valve bodies 8 c and 9 c are guided to the closed position holding seats 8 d and 9 d, respectively, and the first and second opening/closing steps are performed. Valves 8 and 9 may both be closed to block the flow of cerebrospinal fluid from reservoir 11 through main passage 10 and first and second passages 13 and 14 to relief valves 6 and 7.

Further, in this embodiment, as shown in FIGS. 11(1) to 11(d), a circular seat 8d is used to hold the valve bodies 8c and 9c in the closed position.

When moving from 9d to the open position holding circular seats 8c and 9s, the soft upper wall 1! And the soft rear wall 1d, le may be pressed with the fingers 1B over the scalp 16.

Further, the valve bodies 8e, 9c are held in the open position by a circumferential circle fe.
e.

When moving from 9e to the closed position holding circular seats 8d, 9d, the soft upper wall 11 and the soft front wall 1b.

1c can be pressed with the fingers 18 over the scalp 16.

According to this embodiment, the moving direction F1F2 of the valve bodies 8c and 9c
Since the opening/closing valves 8 and 9 are configured to be parallel to each other, the open/closed states of the on-off valves 8 and 9 can be easily checked visually or tactually.

As shown in Figures 15 and 16, the intracranial pressure measuring and ventricular shunt device as the second embodiment of the present invention differs from the first embodiment in the implant A" that is implanted in the patient's body. , the same pressure detection device B as in the first embodiment is used, and in FIGS. 15 and 16, the same reference numerals as in FIGS. 1 to 14 indicate substantially the same components.

In this example, the buried object is a WA with a button-type shutoff mechanism.
The ventricular shunt A# for intracranial pressure measurement has been used, and this ventricular shunt A for intracranial pressure measurement has the function of a flow rate switching type ventricular shunt, and has a shutoff valve mechanism V and a reverse ventricular shunt. The stop valve (miter valve) 4 is different from the first embodiment, and the other configurations are #IIR almost the same as the first embodiment.

This ventricular shunt h#t:p is inserted into the reservoir 1 from the ventricular catheter 2 to the peritoneal catheter 3.
1, a shutoff valve opening pump chamber 31 that communicates with the reservoir 11 via a check valve (miter valve) 4, and a button type shutoff valve 32 as a shutoff valve device #lV that can shut off the flow path 13. They are arranged sequentially.

This button-type cutoff valve 32 is connected to a valve chamber (empty space) 32I that communicates with the pump chamber 31 for opening the cutoff valve of the shunt body 1 and to the peritoneal catheter 3 side flow path 13 via an opening 32e. forming the upper wall surface of the valve chamber 32f;
A flexible membrane 321 that can be dented by receiving an external force from a finger 18 or the like, a valve seat 32c formed around the opening 32e, and a flexible membrane 321 attached to the side wall surface of the valve chamber 321 of the island of the flexible membrane 32. The opening/closing valve is configured as a bush type on-off valve including a protruding valve body 32b that can close the opening 32e when the membrane 321 is pressed downward.

Since the ventricular shunt device for intracranial pressure measurement as the second embodiment of the present invention is constructed as described above, the ventricular shunt device for intracranial pressure measurement with a button-type cutoff mechanism is installed in the ventricular position A#multisite position#J- In the juice ability - (0) ~ (
Intracranial pressure can be measured by the procedure shown in 6), and this embodiment also provides substantially the same effects as the first embodiment.

Furthermore, in order to operate the shutoff valve mechanism V, as shown by the chain line in FIG. At step 8, the flexible membrane 321 of the button-type cutoff valve 32 is pressed through the scalp 16, and the protruding valve body 32b attached to the lower center of the flexible membrane 321 is moved to the intermediate partition membrane 32d, which is the valve seat 32c. The opening 32s is closed by pushing the opening 32e into the opening 32e.

In order to open the cutoff valve mechanism V, press the upper flexible membrane 31J of the pump chamber 31 for opening the cutoff valve, thereby increasing the pressure inside the valve chamber 321 and causing the valve body 32b to close to the opening 32e. By disengaging upward from the shutoff valve ta
V becomes open.

In addition, three or more flow switching units in Embodiment 1.2 may be used to set different regulated flow rates. For example, the minimum flow rate Q may be set to 2" times where base is a natural number. By providing the regulated flow rate, it is possible to switch the flow rate in (2"-1) steps and also provide a mechanism as the shutoff valve mechanism V.

In each of the embodiments described above, orifices with different flow rates may be provided in place of the relief valve 6. A single check valve may be inserted into the main passage 1o.

Further, the first and second flow rate switching sections 5s and 5b may be configured such that the moving directions F, , F of the valve bodies 8c and 9c are perpendicular to the center lines C and L of the shunt body 1.

Furthermore, the valve chambers 8b, 9b and the small chambers 12.12 may be arranged vertically.

〔Effect of the invention〕

As described in detail above, the intracranial pressure measuring ventricle 7 of the present invention
According to the Yant device, the following effects or advantages can be obtained.

(1) When measuring intracranial pressure with the shutoff valve mechanism in the closed state, there is no need to perform pressure zero point adjustment (calibration) for pressure measurement after implantation into the scalp.

(2) The construction can be such that buried objects do not interfere with the tomographic image f'l of a CT scanner, nuclear magnetic resonance scanner, or the like.

(3) It is easy to handle and does not cause invasiveness such as brain damage when not being measured.

0) Burial surgery etc. can be performed easily.

(5) Can be realized at low cost.

(6) By opening the shutoff valve mechanism, it can be used as a normal ventricular shunt.

[Brief explanation of the drawing]

1 to 6 are shown to explain the intracranial pressure measuring means in the intracranial pressure measuring and ventricular shunt device of the present invention.
The figure is the second 70-chart explaining the measurement procedure.
30) to 3(d) are schematic side views showing the measurement procedure, and FIG. 4 is a graph for explaining the action.
Figures 5 and 6 are a schematic perspective view and side view for explaining the measurement principle, and Figures 7 to 14 are Wc1 of the present invention.
This figure shows a ventricular shunt device for intracranial pressure measurement as an example, and FIG. A schematic longitudinal cross-sectional view showing the measurement state (the ventricular shunt is a cross-sectional view taken along the ■-■ arrow in FIG. 7), FIG. 9 is a cross-sectional view taken along the ll-ff arrow in FIG. 7, and FIG. Cross-sectional view taken along the line X-X in the figure, 1st
Figure 1 (is a sectional view taken along the ■-■ arrow in Figure 7, Figure 11 (b)
~(d) are all schematic diagrams for explaining the action at the time of burial, and Figure 12 is a sectional view taken along the ■-n arrow in Figure 7.
13 is a sectional view taken along the line xm-xm in FIG. 7; FIG. 14 is a plan view showing an enlarged section XIV in FIG. 7;
16 is a schematic vertical cross-sectional view and a schematic plan view of a ventricular shunt in a ventricular shunt device for intracranial pressure measurement as a second embodiment of the present invention, and FIGS. FIG. 17 is a schematic diagram showing the overall structure of the means, and FIG. 18 is an enlarged sectional view showing the detection portion thereof. I...Shunt body (relay room), IP/soft upper wall, 1
b, 1 c... Soft anterior wall, 1 d, I C... Soft posterior wall, 2... Ventricular catheter, 21... Soft Iku, 2b...
◆ Tip f1 part, 3... Peritoneal catheter, 3J... Base end part,
4.. Check valve, 5.. Flow rate switching mechanism, 51.. 1st flow rate switching section, 5b.. 2nd flow rate switching section, 6.. Slit type relief valve as first flow rate adjustment section, 6a...Slit, 7...Slit type relief valve as second flow rate adjustment part, 71...Slit, 8...Pole type on/off valve as Ml on/off valve 8P/Circular valve seat, 8b...Valve chamber (Upstream compartment), 8c...Movable spherical valve body, 8d...Circular seat for holding the closed position, 8c...Circle seat for holding the open position, 9...Second
Pole type on-off valve, 9P/circular valve seat, 9
b... Valve chamber (upstream compartment), 9c... Movable spherical valve body,
9d...Circular seat for holding the closed position, 9c...Circle seat for holding the open position, 1O...Main passage, 1o1...Branch portion, 11...Reservoir, 1h...Thin film-like flexible curve for intracranial pressure measurement Dome, I2...Small chamber (downstream compartment), 13...First channel, 14...Second channel, 15...Sewing thread through hole, I6
... Scalp, I7 ... Skull, 18 ... Finger, 19 ... Ventricle, 2o ... Brain, 21 ... Dura mater, 22 ... Buried object body, 2
3...Pressure detector, 23! ...Case, 23b...Outer cylinder as a guide part, 23c...Press plate, 23d...Column pressure receiving part, 23e...Diffusion type semiconductor pressure sensor (load sensor), 2:31...Zero adjuster, 24.・Lead wire, 25...Amplifier, 26...Amplifier, 27...Recorder as an external device, 28...Display device as an external device,
29... Plate, 30... Detection end, 31... Pump chamber for opening the cutoff valve, 31a... Flexible membrane, 32... Button type cutoff valve (
Bush type on-off valve), 321...Flexible membrane, 32b...Protruding valve body, 32c...Valve seat, 32d...Intermediate partition membrane,
32P・Opening, 32f・Valve chamber (empty space), 33・・Relief valve attached member, A・・Embedded object, A′, A″・・ventricular shunt for intracranial pressure measurement as buried object, B・・Pressure detection device, C, L...center line, ■...shutoff valve mechanism.

Claims (3)

[Claims] (1) A ventricular catheter whose tip is inserted into the ventricle of the brain to drain cerebrospinal fluid from the ventricle, and a catheter whose tip is inserted into the peritoneal cavity or atrium to discharge the cerebrospinal fluid to the peritoneal cavity or atrium. a shunt body connected to the proximal end of the ventricular catheter and the proximal end of the peritoneal catheter or atrial catheter, respectively, to communicate the catheters; and the peritoneal catheter or atrial catheter. The shunt body is provided with a check valve capable of preventing backflow of cerebrospinal fluid from the ventricular catheter to the ventricular catheter, and the shunt body is capable of blocking the flow of cerebrospinal fluid from the ventricular catheter to the peritoneal catheter or the atrial catheter. a shutoff valve mechanism; and an intracranial pressure measurement reservoir that is inserted into the flow path on the side of the ventricular catheter from the shutoff valve mechanism, and is implanted under the scalp and placed on the skull to guide the cerebrospinal fluid. A flexible convex curved dome for measuring intracranial pressure is provided at the upper part of the reservoir, and is formed to protrude outward and is expanded by the pressure of the cerebrospinal fluid and can be bent in response to pressure from an external force. , a detection end comprising a guide part that can contact the convex curved dome from the outside through the scalp, and a pressure receiving part whose tip is formed so as to be substantially flush with the tip of the guide part, and the detection end. A ventricular shunt device for measuring intracranial pressure, characterized by comprising a pressure sensor connected to a pressure receiving part of the pressure sensor, and an external device that receives and displays or records a detection signal from the pressure sensor. (2) The shutoff valve mechanism opens and closes by aligning with the valve seat formed on the wall surface of the shunt body, the valve chamber formed in the shunt body upstream of the valve seat, and the valve seat. A patent claim configured as a pole-type open/close valve, which includes a spherical movable valve body enclosed in the valve chamber so that the valve can be moved to a position where the valve can be closed by receiving a driving force from outside of the shunt body. The intracranial pressure measuring and ventricular shunt device according to item 1. (3) a cavity in which the shutoff valve mechanism communicates with the reservoir of the shunt body and with the peritoneal catheter side channel through an opening; and a flexible membrane forming an upper wall surface of the cavity; A valve seat formed around the opening, and a protruding valve body that is attached to a side wall surface of the cavity of the flexible membrane and can close the valve seat when the flexible membrane is pressed downward. The intracranial pressure measuring and ventricular shunt device according to claim 1, which is configured as a button-type on-off valve.