Diminished plantar grasp response as an additional indicator of a shunt malfunction in a case of congenital hydrocephalus

2001 ◽  
Vol 17 (7) ◽  
pp. 415-418 ◽  
Author(s):  
Not Available Not Available ◽  
Not Available Not Available
Keyword(s):  
Shunt Malfunction ◽  
Congenital Hydrocephalus

scholarly journals Visual Disturbance Following Shunt Malfunction in a Patient With Congenital Hydrocephalus

2012 ◽  
Vol 52 (11) ◽  
pp. 835-838 ◽  
Author(s):  
Hirofumi OYAMA ◽  
Kenichi HATTORI ◽  
Akira KITO ◽  
Hideki MAKI ◽  
Tomoyuki NODA ◽  
...  
Keyword(s):  
Visual Disturbance ◽  
Shunt Malfunction ◽  
Congenital Hydrocephalus

A CASE OF FETAL DYSTOCIA DUE TO CONGENITAL HYDROCEPHALUS WITH MICROMELIA IN A PUG AND ITS MANAGEMENT

2019 ◽  
Vol 11 (1) ◽  
pp. 058
Author(s):  
M.S. Bawaskar ◽  
S.K. Sahatpure ◽  
S.S. Bawaskar ◽  
G.S. Nalkande ◽  
V.U. Takle ◽  
...  
Keyword(s):  
Congenital Hydrocephalus

Reliability of the radiopharmaceutical shunt flow study for the detection of a CSF shunt malfunction in the presence of stable ventricular size

2020 ◽  
Vol 26 (4) ◽  
pp. 364-370
Author(s):  
Jeffrey J. Quezada ◽  
J. Gordon McComb
Keyword(s):  
Ct Scan ◽  
Operative Intervention ◽  
Shunt Malfunction ◽  
Shunt Revision ◽  
Csf Shunt ◽  
Technical Failure ◽  
Ventricular Size ◽  
Shunt Flow ◽  
Programmable Valve ◽  
Flow Study

OBJECTIVEThe authors sought to determine the reliability of a radiopharmaceutical (RP) shunt flow study for the detection of a CSF-diverting shunt malfunction in the presence of stable ventricular size.METHODSAfter the authors obtained IRB approval, all CSF RP shunt flow studies done between January 1, 2014, and January 1, 2019, in pediatric patients at Children’s Hospital Los Angeles were identified. Included in the study were only those patients in whom an MRI or CT scan was done during the hospital admission for shunt malfunction and showed no increase in ventricular size compared with the most recent prior MRI or CT scan when the patient was asymptomatic. Data recorded for analysis were patient age and sex, etiology of the hydrocephalus, shunt distal site, nonprogrammable versus programmable valve, operative findings if the shunt was revised, and follow-up findings for a minimum of 90 days after admission. The RP shunt flow study consisted of tapping the reservoir and injecting technetium-99m DTPA according to a set protocol.RESULTSThe authors identified 146 RP flow studies performed in 119 patients meeting the above criteria. Four of the 146 RP studies (3%) were nondiagnostic secondary to technical failure and were excluded from statistical analysis. Of the 112 normal flow studies, operative intervention was not undertaken in 102 (91%). The 10 (9%) remaining normal studies were performed in patients who underwent operative intervention, in which 8 patients had a proximal obstruction, 1 had a distal obstruction, and 1 patient had no obstruction. Of the 30 patients with abnormal flow studies, symptoms of shunt malfunction subsided in 9 (30%) patients and these patients did not undergo operative intervention. Of the 21 (70%) operated patients, obstruction was proximal in 9 patients and distal in 5, and for 7 patients the shunt tubing was either fractured or disconnected. Regression analysis indicated a significant association between the flow study interpretation and the odds for shunt revision (OR 27, 95% CI 10–75, p < 0.0001). No other clinical variables were significant. The sensitivity of a shunt flow study alone for detection of shunt malfunction in cases with stable ventricular size was the same as a shunt flow study plus an MRI or CT (70% vs 70%), but performing a shunt flow in addition to MRI or CT did increase the specificity from 92% to 100% and the accuracy from 87% to 94%.CONCLUSIONSRP shunt flow studies were of definite value in deciding whether to operatively intervene in patients with symptoms of shunt malfunction in whom no change in ventricular size was detected on current MRI or CT scans compared to scans obtained when the patients were asymptomatic.

Radiographic assessment of snap-shunt failure

2010 ◽  
Vol 6 (3) ◽  
pp. 299-302 ◽  
Author(s):  
Anand I. Rughani ◽  
Bruce I. Tranmer ◽  
Jeffrey E. Florman ◽  
James T. Wilson
Keyword(s):  
Normal Values ◽  
Clinical Symptoms ◽  
Type System ◽  
Shunt Malfunction ◽  
Ct Scans ◽  
Shunt Revision ◽  
Ventricular Catheter ◽  
Shunt Failure ◽  
Shunt System ◽  
Ct Finding

Accurate assessment of imaging studies in patients with ventriculoperitoneal shunts can be aided by empirical findings. The authors characterize an objective measurement easily performed on head CT scans with the goal of producing clear evidence of shunt fracture or disconnection in patients with a snap shunt–type system. The authors describe 2 cases of ventriculoperitoneal shunt failure involving a fracture and a disconnection associated with a snap-shunt assembly. In both cases the initial clinical symptoms were not convincing for shunt malfunction, and the interpretation of the CT finding failed to immediately identify the abnormality. As the clinical picture became more convincing for shunt malfunction, each patient subsequently underwent successful shunt revision. The authors reviewed the CT scans of 10 patients with an intact and functioning snap-shunt system to characterize the normal appearance of the snap-shunt connection. On CT scans the distance between the radiopaque portion of the ventricular catheter and the radiopaque portion of the reservoir dome measures an average of 4.72 mm (range 4.6–4.9 mm, 95% CI 4.63–4.81 mm). In the authors' patient with a fractured ventricular catheter, this interval measured 7.8 mm, and in the patient with a disconnection it measured 7.7 mm. In comparison with the range of normal values, a radiolucent interval significantly greater than 4.9 mm should promptly raise concern for a disconnected or fractured shunt in this system. This measurement may prove particularly useful when serial imaging is not readily available.

Congenital hydrocephalus case study: pathophysiology, treatment and prognosis

2013 ◽  
Vol 18 (5) ◽  
pp. 206-209 ◽  
Author(s):  
Elena Scarpante ◽  
Viktor Palus ◽  
Giunio Bruto Cherubini ◽  
Dick White
Keyword(s):  
Congenital Hydrocephalus
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