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Chapter 23 - Hydrocephalus and Shunt Evaluation

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

By
Kristen Stabingas ,
Diana J. Jho ,
Raj Nangunoori ,
Alexander K. Yu  and
Jody Leonardo
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

Hydrocephalus is an extremely common neurological condition encountered in the emergency department (ED). The condition is characterized by symptomatic inability to drain or resorb CSF, resulting in pressure build-up within the brain. Hydrocephalus can result from both congenital and acquired etiologies, many of which can respond to shunting. The symptoms of hydrocephalus are classically due to an increase in intracranial pressure (ICP); however, normal- or low-pressure variants can occur. Hydrocephalus can result from a blockage within the ventricular system (“obstructive”) or outside the ventricular system (“communicating”), thereby impairing CSF absorption into the cerebral venous sinuses. Hydrocephalus may also be caused by failure of CSF to be absorbed secondary to abnormalities in the brain parenchyma itself.

Keywords

congenitalacquiredprogrammable valve settingParinaud’s syndromefontanelleoccipital frontal circumference (OFC) hydrocephalusshunt evaluation
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 334 - 345
Publisher: Cambridge University Press
Print publication year: 2023

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References

Bartynski, WS, Valliappan, S, Uselman, JH, Spearman, MP. The adult radiographic shuntogram. AJNR Am J Neuroradiol 2000;21(4):721–726.Google Scholar
Browd, SR, Ragel, BT, Gottfried, ON, Kestle, JR. Failure of cerebrospinal fluid shunts: part I. Obstruction and mechanical failure. Pediatr Neurol 2006;34(2):83–92.Google Scholar
Browd, SR, Gottfried, ON, Ragel, BT, Kestle, JR. Failure of cerebrospinal fluid shunts: part II. Overdrainage, loculation, and abdominal complications. Pediatr Neurol 2006;34(3):171–176.CrossRefGoogle ScholarPubMed
Chiewvit, S, Nuntaaree, S, Kanchaanapiboon, P, Chiewvit, P. Assessment lumboperitoneal or ventriculoperitoneal shunt patency by radionuclide technique: a review experience cases. World J Nucl Med 2014;13(2):75–84.Google Scholar
Dewey, RC, Kosnik, EJ, Sayers, MP. A simple test of shunt function: the shuntogram. J Neurosurg 1976;44:121–126.Google Scholar
Di Rocco, C, Caldwell, M. Surveillance of CSF shunt function. In Di Rocco, C (ed.) The Treatment of Infantile Hydrocephalus. CRC Press, 1987.Google Scholar
Hayden, PW, Rudd, TG, Shurtleff, DB. Combined pressure-radionuclide evaluation of suspected cerebrospinal fluid shunt malfunction: a seven-year clinical experience. Pediatrics 1980;66(5):679–684.Google Scholar
Khan, AA, Jabbar, A, Banerjee, A, Hinchley, G. Cerebrospinal shunt malfunction: recognition and emergency management. Br J Hosp Med (Lond) 2007;68(12):651–655.Google Scholar
Masinda, AJ, Guazzo, EG. Blocked ventriculoperitoneal shunt causing raised intracranial pressure diagnosed by prominent sinus pericranii. J Clin Neurosci 2009;16(12):1686–1687.Google Scholar
Ouellette, D, Lynch, T, Bruder, E, et al. Additive value of nuclear medicine shuntograms to computed tomography for suspected cerebrospinal fluid shunt obstruction in the pediatric emergency department. Pediatr Emerg Care 2009;25(12):827–830.Google Scholar
Rekate, HL. Shunt revision: complications and their prevention. Pediatr Neurosurg 1991;17(3):155–162.Google Scholar
Rocque, BG, Lapsiwala, S, Iskandar, BJ. Ventricular shunt tap as a predictor of proximal shunt malfunction in children: a prospective study. J Neurosurg Pediatr 2008;1(6):439–443.Google Scholar
Savoiardo, M, Solero, CL, Passerini, A, Migliavacca, F. Determination of cerebrospinal fluid shunt function with water-soluble contrast medium. J Neurosurg 1978;49:398–407.CrossRefGoogle ScholarPubMed
Sekhar, LN, Moossy, J, Guthkelch, AN. Malfunctioning ventriculoperitoneal shunts. Clinical and pathological features. J Neurosurg 1982;56(3):411–416.Google Scholar
Thompson, EM, Wagner, K, Kronfeld, K, Selden, NR. Using a 2-variable method in radionuclide shuntography to predict shunt patency. J Neurosurg 2014;121(6):1504–1507.CrossRefGoogle ScholarPubMed
Vassilyadi, M, Tataryn, ZL, Matzinger, MA, Briggs, V, Ventureyra, EC. Radioisotope shuntograms at the Children’s Hospital of Eastern Ontario. Childs Nerv Syst 2006;22(1):43–49.Google Scholar
Vernet, O, Farmer, JP, Lambert, R, Montes, JL. Radionuclide shuntogram: adjunct to manage hydrocephalic patients. J Nucl Med 1996;37(3):406–41.Google Scholar

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