Surgical treatment of hydrocephalus depends on successful bypass of an obstructive process within the ventricular system or, if this is impossible, diversion of the cerebrospinal fluid stream from its normal channels within the central nervous system. Development of competent one-way valves, well tolerated by the tissues, has made it possible to divert the fluid into the blood stream without the hazard of reversal of flow and consequent blockage of the shunt system. Experience has shown that successful shunting requires placement of the distal tube in a portion of the blood stream with rapid flow and turbulence. Under such conditions the hazard of clotting around the tubing is minimized, while more peripheral placement in smaller venous channels results in frequent failure due to clotting and vascular occlusion. Optimum placement, therefore, is in the right atrium or at the junction of the superior vena cava and atrium via the right jugular vein.
McLAURIN RL, GLASS IH, KAPLAN S. Ventriculoatrial Shunt for HydrocephalusElectrocardiographic Control for Accurate Placement. Am J Dis Child. 1963;105(2):216–218. doi:10.1001/archpedi.1963.02080040218016