Failure of cerebrospinal fluid shunts: part I: Obstruction and mechanical failure.

Ventricular shunts are commonly employed to treat children with hydrocephalus. Complications from shunts are common and can present with a variety of signs and symptoms. This pair of reviews discusses the common findings in patients with shunt malfunction, including physical examination and imaging findings. Part I of the series discusses obstruction and mechanical failure of shunts; Part II discusses overdrainage, loculation, and abdominal complications of shunts. An understanding of the presentation and etiology of shunt dysfunction is critical for neurologists and pediatricians who often are the first to evaluate and triage these children.

[1]  H. James,et al.  Pitfalls in the diagnosis of arrested hydrocephalus , 2005, Acta Neurochirurgica.

[2]  J. Drake,et al.  Long-Term Follow-Up Data from the Shunt Design Trial , 2000, Pediatric Neurosurgery.

[3]  J. Ojemann,et al.  A critical analysis of 'normal' radionucleotide shuntograms in patients subsequently requiring surgery , 2003, Child's Nervous System.

[4]  P. Uvebrant,et al.  Evaluation of cerebrospinal fluid shunt function in hydrocephalic children using 99mTc-DTPA , 1992, Child's Nervous System.

[5]  K. Muraszko,et al.  Shunt failure without ventriculomegaly proclaimed by ophthalmic findings. , 1994, Journal of neurosurgery.

[6]  N. Tribolet,et al.  Long-term results after ventriculo-atrial shunting in children , 1995, Child's Nervous System.

[7]  J. H. Piatt Pumping the Shunt Revisited , 1996 .

[8]  R. Jones,et al.  The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. , 1994, Minimally invasive neurosurgery : MIN.

[9]  James M. Drake,et al.  Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus , 2000 .

[10]  J. Drake,et al.  Predicting shunt failure on the basis of clinical symptoms and signs in children. , 2001, Journal of neurosurgery.

[11]  W. Boydston,et al.  Shunt Revision by Coagulation with Retention of the Ventricular Catheter , 1998, Pediatric Neurosurgery.

[12]  J. Drake,et al.  Determination of cerebrospinal fluid shunt obstruction with magnetic resonance phase imaging. , 1991, Journal of neurosurgery.

[13]  S J Schiff,et al.  Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. , 1998, Neurosurgery.

[14]  J. Chandler,et al.  Increased risk of distal ventriculoperitoneal shunt obstruction associated with slit valves or distal slits in the peritoneal catheter. , 1997, Journal of neurosurgery.

[15]  J. Mealey,et al.  Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. , 1979, Journal of neurosurgery.

[16]  J. Piatt,et al.  A search for determinants of cerebrospinal fluid shunt survival: retrospective analysis of a 14-year institutional experience. , 1993, Pediatric neurosurgery.

[17]  D. Woollam,et al.  Surface ultrastructure of tissues occluding ventricular catheters. , 1978, Journal of neurosurgery.

[18]  E. Aldrich,et al.  Disconnection as a cause of ventriculoperitoneal shunt malfunction in multicomponent shunt systems. , 1990, Pediatric neurosurgery.

[19]  Ian F. Pollack,et al.  A Randomized, Controlled Study of a Programmable Shunt Valve versus a Conventional Valve for Patients with Hydrocephalus , 1999 .

[20]  R. Aurisch,et al.  Evaluation of shunt function in hydrocephalic patients with the radionuclide 99mTc-pertechnetate , 1999, Child's Nervous System.