Cerebrospinal fluid (CSF) shunt: Surgically inserted drain that routes excess CSF in ventricles to site where it is absorbed or collected
Proximal catheter is positioned in ventricular system
Reservoir with valve is located underneath scalp
Distal catheter ends in draining space
Ventriculoperitoneal (VP) shunt
Peritoneal cavity preferred since distal site has considerably better absorptive capacity and accessibility
Ventriculopleural (VPL) shunt
Ventriculoatrial (VA) shunt
Endoscopic 3rd ventriculostomy
New alternative to shunting
Small opening in floor of 3rd ventricle allows free flow of intraventricular CSF into subarachnoid space
Used in patients with uncomplicated noncommunicating hydrocephalus caused by aqueductal stenosis or space-occupying lesions
Low infection risk
Symptoms gradually resolve (weeks to months)
IMAGING
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Selected References
Schmieder S et al: CSF-oma identification with nuclear medicine shunt-o-gram. Clin Nucl Med. 44(5):399-400, 2019
Bermo MS et al: Two signs indicative of successful access in nuclear medicine cerebrospinal fluid diversionary shunt studies. Pediatr Radiol. 48(8):1130-8, 2018
Kale HA et al: Intracranial perishunt catheter fluid collections with edema, a sign of shunt malfunction: Correlation of CT/MRI and nuclear medicine findings. AJNR Am J Neuroradiol. 38(9):1754-7, 2017
Nigim F et al: Shunting for hydrocephalus: analysis of techniques and failure patterns. J Surg Res. 191(1):140-7, 2014
Sivaganesan A et al: Neuroimaging of ventriculoperitoneal shunt complications in children. Pediatr Radiol. 42(9):1029-46, 2012
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References
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KEY FACTS
Imaging
Top Differential Diagnoses
TERMINOLOGY
Definitions
Cerebrospinal fluid (CSF) shunt: Surgically inserted drain that routes excess CSF in ventricles to site where it is absorbed or collected
Proximal catheter is positioned in ventricular system
Reservoir with valve is located underneath scalp
Distal catheter ends in draining space
Ventriculoperitoneal (VP) shunt
Peritoneal cavity preferred since distal site has considerably better absorptive capacity and accessibility
Ventriculopleural (VPL) shunt
Ventriculoatrial (VA) shunt
Endoscopic 3rd ventriculostomy
New alternative to shunting
Small opening in floor of 3rd ventricle allows free flow of intraventricular CSF into subarachnoid space
Used in patients with uncomplicated noncommunicating hydrocephalus caused by aqueductal stenosis or space-occupying lesions
Low infection risk
Symptoms gradually resolve (weeks to months)
IMAGING
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Selected References
Schmieder S et al: CSF-oma identification with nuclear medicine shunt-o-gram. Clin Nucl Med. 44(5):399-400, 2019
Bermo MS et al: Two signs indicative of successful access in nuclear medicine cerebrospinal fluid diversionary shunt studies. Pediatr Radiol. 48(8):1130-8, 2018
Kale HA et al: Intracranial perishunt catheter fluid collections with edema, a sign of shunt malfunction: Correlation of CT/MRI and nuclear medicine findings. AJNR Am J Neuroradiol. 38(9):1754-7, 2017
Nigim F et al: Shunting for hydrocephalus: analysis of techniques and failure patterns. J Surg Res. 191(1):140-7, 2014
Sivaganesan A et al: Neuroimaging of ventriculoperitoneal shunt complications in children. Pediatr Radiol. 42(9):1029-46, 2012
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