Investigating shunt function using continuous intracranial pressure monitoring in adults: single center experience

Clinical article

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Object

Managing symptomatic ventriculoperitoneal shunts with no clear evidence of shunt malfunction either clinically or radiologically can be a difficult task. The aim of this study was to assess intracranial pressure (ICP) monitoring as a method of investigating shunt function.

Methods

The authors performed a retrospective analysis of 38 continuous ICP monitoring procedures done in patients with ventriculoperitoneal shunts and suspected shunt malfunction.

Results

Thirty-eight procedures were performed in 31 patients between January 2005 and October 2008. Sixteen recordings were normal, 6 revealed overdrainage or low pressure, 11 indicated underdrainage or high pressure, and 5 showed variable shunt function. Based on the findings after 20 procedures (53%), patients were treated conservatively: 4 by readjusting the valve setting and 16 by referral to the headache neurologist for medical treatment. Forty-five percent of the conservatively treated patients improved. Surgical exploration was undertaken following 18 procedures (47%); 72% of the surgically treated patients improved.

Conclusions

Continuous ICP monitoring using an intraparenchymal probe is a safe and effective method of investigating adult hydrocephalus.

Abbreviations used in this paper: ICP = intracranial pressure; VP = ventriculoperitoneal.
Article Information

Contributor Notes

Address correspondence to: Ahmed K. Toma, F.R.C.S.(Neuro Surg), Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom. email: Ahmedktoma@yahoo.com.Please include this information when citing this paper: published online August 27, 2010; DOI: 10.3171/2010.8.JNS1067.

© AANS, except where prohibited by US copyright law.

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