A simple test of shunt function: the shuntgram

Technical note

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✓ The authors present an x-ray film method to ascertain the function of ventricular shunts in hydrocephalic patients. No special equipment is required. Representative x-ray films and analysis of results in 131 determinations are presented.

Article Information

Address reprint requests to: Richard C. Dewey, M.D., Box 1067, Missoula, Montana 59801.

© AANS, except where prohibited by US copyright law.

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Figures

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    The normal shuntgram. Left: One to 2 cc of CSF were aspirated from the Holter reservoir, and 2 cc of Conray dye were injected while this picture was made. There are no structural abnormalities. Right: Three minutes later there is complete clearing (arrow).

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    Abnormal shuntgram. Injected Conray dye extravasates through a shunt disconnection in the neck (arrow).

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    Abnormal shuntgram. Left: The tip of the venous catheter is at the T3 level (large arrow). There is reflux of Conray dye through a mesothelial sleeve (small arrows). Right: Twelve minutes later, after pumping reservoir, there is no clearing (arrow).

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    Questionable shuntgram. Left: Injection of Conray dye shows shunt disconnection in the neck (large arrow). The distal venous catheter looks normal (small arrows). Right: The 3-minute film shows complete clearing of the Holter reservoir (large arrow) and distal catheter (small arrows).

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    Normal shuntgram of a Pudenz ventriculojugular shunt, with complete clearing in 3 minutes (arrow).

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    Normal shuntgram of a Holter ventriculoperitoneal shunt. Three minute film (right) shows complete clearing of reservoir (large arrow) and distal catheter (small arrows).

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    Subdural or subarachnoid injection of Conray dye. Note needle passing through the reservoir. There were no sequelae of this inadvertant injection.

References

  • 1.

    Andersson HLofgren J: Hydrodynamic evaluation of shunt performance in hydrocephalus. Dev Med Child Neurol Suppl 16:30341968Andersson H Lofgren J: Hydrodynamic evaluation of shunt performance in hydrocephalus. Dev Med Child Neurol Suppl 16:30–34 1968

  • 2.

    Atkinson JRShurtleff DBFoltz EL: Radio telemetry for the measurement of intracranial pressure. J Neurosurg 27:4284321967Atkinson JR Shurtleff DB Foltz EL: Radio telemetry for the measurement of intracranial pressure. J Neurosurg 27:428–432 1967

  • 3.

    Davidoff LMChamlin M: The “fontanometer”: adaptation of the Schiotz tonometer for the determination of intracranial pressure in the neonatal and early periods of infancy. Pediatrics 24:106510681959Davidoff LM Chamlin M: The “fontanometer”: adaptation of the Schiotz tonometer for the determination of intracranial pressure in the neonatal and early periods of infancy. Pediatrics 24:1065–1068 1959

  • 4.

    Forrest DMTsingoglou S: The false fontanelle as a practical method of long-term testing of intracranial pressure. Dev Med Child Neurol Suppl 16:17 +1968Forrest DM Tsingoglou S: The false fontanelle as a practical method of long-term testing of intracranial pressure. Dev Med Child Neurol Suppl 16:17 + 1968

  • 5.

    Go KGLakke JPBeks JW: A harmless method for the assessment of the patency of ventriculoatrial shunts in hydrocephalus. Dev Med Child Neurol Suppl 16:100 +1968Go KG Lakke JP Beks JW: A harmless method for the assessment of the patency of ventriculoatrial shunts in hydrocephalus. Dev Med Child Neurol Suppl 16:100+ 1968

  • 6.

    Hoppenstein R: A device for measuring intracranial pressure: Lancet 1:90911965Hoppenstein R: A device for measuring intracranial pressure: Lancet 1:90–91 1965

  • 7.

    Jeppsson S: Echoencephalography V. A method for recording the intracranial pressure with the aid of echoencephalographic technique. A preliminary report. Acta Chir Scand 128:2182241964Jeppsson S: Echoencephalography V. A method for recording the intracranial pressure with the aid of echoencephalographic technique. A preliminary report. Acta Chir Scand 128:218–224 1964

  • 8.

    Matin PGoodwin DADeNardo GL: Cerebrospinal fluid scanning and ventricular shunts. Radiology 94:4354381970Matin P Goodwin DA DeNardo GL: Cerebrospinal fluid scanning and ventricular shunts. Radiology 94:435–438 1970

  • 9.

    Rowan JORobertson JS: Evaluation of surgical ventricular shunts using sodium pertechnetate (Na99TcmO4). Br J Radiol 43:8311970Rowan JO Robertson JS: Evaluation of surgical ventricular shunts using sodium pertechnetate (Na99TcmO4). Br J Radiol 43:831 1970

  • 10.

    Shulman KMarmarou A: Analysis of intracranial pressure in hydrocephalus. Dev Med Child Neurol Suppl 16:11161968Shulman K Marmarou A: Analysis of intracranial pressure in hydrocephalus. Dev Med Child Neurol Suppl 16:11–16 1968

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