CPT® Code 62180

Ventriculocisternostomy, specifically the Torkildsen type operation, is a neurosurgical procedure designed to alleviate conditions caused by obstructions in the cerebral aqueduct, which can lead to increased intracranial pressure and hydrocephalus. This procedure involves the placement of a shunt that connects the lateral ventricle of the brain to the cisterna magna, a space located at the base of the skull that contains cerebrospinal fluid (CSF). The primary goal of this operation is to create an alternative pathway for CSF flow, effectively bypassing the obstruction and allowing for proper drainage. The procedure begins with a curved incision in the scalp, which is then flapped forward to provide access to the underlying structures. A craniotomy is performed to expose the dura mater, the protective covering of the brain. Once the dura is incised, a Torkildsen shunt is inserted into the lateral ventricle, with the distal end of the catheter positioned in the cisterna magna. Although this technique was once a common approach for treating obstructive hydrocephalus, it has largely been supplanted by more advanced procedures, such as neuroendoscopic third ventricle ventriculocisternography, which offer less invasive options and improved outcomes.