Murakami Xiaoyu ：Question for @Professor Li Xiaoyong：Hello Professor Li, what is your general opinion on intracranial infection? Prof. Li Xiaoyong
: I have been following the various issues that have been raised in the last two weeks or so, and they are all very critical, but basically they don’t address the deeper content behind these issues. The deeper aspects of the problem are very complex because it involves many aspects of cerebrospinal fluid infection, and the understanding of cerebrospinal fluid-associated intracranial infection is still at a very superficial stage both in China and abroad. It is not easy to fully elaborate on these issues because there is still a lot of content to be studied in depth. Now I will try to answer the specific questions raised online with clinical information and give as profound answers as I know how, with special attention: my explanations are different from those reported in the classical literature or some expert guidelines prevalent in China recently, but I have sufficient evidence to show that I am more correct. The “classic cases” on my website www.CSFneurosurg.com (cerebrospinal neurosurgery website), you can definitely still experience a lot of content. In addition, much of the content of cerebrospinal fluid neurosurgery is basically new and still evolving: although the incidence may seem low, with the advantage of patient concentration after the establishment of a specialized department, new and special cases are encountered every year, becoming a source of continuous enrichment and expansion of knowledge in cerebrospinal fluid. Please understand that the answers we give here are not immune to errors, but please believe that the theory of cerebrospinal fluid neurosurgery will continue to improve along the right direction in the ongoing exploration. scriptjava：To @Professor Li Xiaoyong
Q: Hi Prof. Li, how effective is the use of anti-infective cerebrospinal fluid shunts to treat hydrocephalus and how effective is the preoperative treatment of the shunts with antibiotic flushing or soaking to reduce shunt infection? Prof. Li Xiaoyong
: Infection in hydrocephalus shunts is the most serious complication after hydrocephalus surgery, so it is critical to prevent infection. Johnson & Johnson has anti-infection shunts, which is a shunt infection prevention method that is soaked with antibiotics and can slowly release antibiotics; Medtronic also has a special (more adsorbent to drugs) shunt that advocates preoperative soaking with antibiotics, which is basically the same idea. In the past or present, others have used antibiotics such as vancomycin to treat all kinds of shunts by soaking them. This is only one way to prevent shunt infections, but there are two aspects that cannot be solved: one is the type of bacteria, and the current use of soaked antibiotics does not kill all types of bacteria; second, the causes of shunt infections also include patients who already have intracranial or cerebrospinal fluid infections such as those who have passed through the lumbar pool or ventricular drainage before shunt surgery. Furthermore, special attention should be paid to the impact of patient immunity such as preoperative patient frailty, the elderly, post-traumatic hydrocephalus patients with unhealthy skin and some people with surgical incisions that do not heal easily or even bypass head and abdominal incisions that are open, so we need to try to find more reasonable surgical strategies.