Reaction of rabbit lateral periventricular tissue to shunt tubing implants

The reaction of the periventricular tissue of the lateral ventricle to silicone rubber shunt tubing was studied by scanning and transmission electron microscopy. Nonfunctioning shunt tubing was implanted bilaterally into the frontal horns of rabbits, which were then sacrificed at postoperative intervals of 3 days to 16 weeks. Colchicine was used to study mitotic activity at the 3-day to 4-week postimplantation intervals. Reactive changes that occurred in the periventricular tissue correlated with the degree of contact with the implant and also with the duration of the postoperative period. Ependymal cells underwent progressive attenuation and sloughed completely in the most severely affected areas. Prominent gliosis in the subependyma accompanied the ependymal changes. The ventricular surface directly adjacent to holes in the implant developed ependyma-covered glial evaginations which grew into the implant holes beginning 1 week postimplantation. In the region of the outgrowths, ependymal mitotic activity was significantly increased at 1 and 2 weeks postimplantation. and astroglial mitotic activity was increased at 3 days and 1 week. Proliferation of ependymal and glial cells in the area touching the shunt tubing and mechanical factors contributed to the development of cellular outgrowths which may be a factor in the pathogenesis of shunt obstruction in human hydrocephalus.