General term for enlargement of cerebral ventricles
Hydrocephalus (HCP)
Enlargement of cerebral ventricles secondary to abnormal CSF formation, flow, or absorption resulting in ↑ CSF volume
Subset of ventriculomegaly
Onset over days (acute), weeks (subacute), or months to years (chronic)
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nonvascular Interventions
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Fowler JB et al: Ventriculoperitoneal shunt, 2020
Kaestner S et al: Revision surgery following CSF shunt insertion: how often could it be avoided? Acta Neurochir (Wien). 162(1):9-14, 2020
Mohammad SA et al: The value of CSF flow studies in the management of CSF disorders in children: a pictorial review. Insights Imaging. 10(1):3, 2019
Ezzat AAM et al: Migration of the distal catheter of ventriculoperitoneal shunts in pediatric age group: case series. World Neurosurg. 119:e131-7, 2018
Kraemer MR et al: Overdrainage-related ependymal bands: a postulated cause of proximal shunt obstruction. J Neurosurg Pediatr. 1-11, 2018
Ros B et al: Shunt overdrainage syndrome: review of the literature. Neurosurg Rev. 41(4):969-81, 2018
Hanak BW et al: Cerebrospinal fluid shunting complications in children. Pediatr Neurosurg. 52(6):381-400, 2017
Rinker EK et al: CSF shunt complications: what the abdominal imager needs to know. Abdom Imaging. 40(6):2030-40, 2015
Symss NP et al: Is there an ideal shunt? A panoramic view of 110 years in CSF diversions and shunt systems used for the treatment of hydrocephalus: from historical events to current trends. Childs Nerv Syst. 31(2):191-202, 2015
Koktekir E et al: Resolution of papilledema after endoscopic third ventriculostomy versus cerebrospinal fluid shunting in hydrocephalus: a comparative study. J Neurosurg. 120(6):1465-70, 2014
Bateman GA: Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt? J Neurosurg. 119(6):1503-10, 2013
Rasul FT et al: Is endoscopic third ventriculostomy superior to shunts in patients with non-communicating hydrocephalus? A systematic review and meta-analysis of the evidence. Acta Neurochir (Wien). 155(5):883-9, 2013
Symss NP et al: Theories of cerebrospinal fluid dynamics and hydrocephalus: historical trend. J Neurosurg Pediatr. 11(2):170-7, 2013
Robinson S: Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts. J Neurosurg Pediatr. 9(3):242-58, 2012
Sivaganesan A et al: Neuroimaging of ventriculoperitoneal shunt complications in children. Pediatr Radiol. 42(9):1029-46, 2012
Chan M et al: Prediction of ventriculoperitoneal shunt dependency in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg. 110(1):44-9, 2009
Peraud A et al: Decompensated hydrocephalus causing syringomyelia and tetraparesis: a case report. Childs Nerv Syst. 25(2):263-6, 2009
Willis B et al: Ventricular reservoirs and ventriculoperitoneal shunts for premature infants with posthemorrhagic hydrocephalus: an institutional experience. J Neurosurg Pediatr. 3(2):94-100, 2009
Dusick JR et al: Success and complication rates of endoscopic third ventriculostomy for adult hydrocephalus: a series of 108 patients. Surg Neurol. 69(1):5-15, 2008
Ellis MJ et al: Treatment of recurrent ventriculoperitoneal shunt failure associated with persistent cerebrospinal fluid eosinophilia and latex allergy by use of an "extracted" shunt. J Neurosurg Pediatr. 1(3):237-9, 2008
James HE et al: Management of complicated shunt infections: a clinical report. J Neurosurg Pediatr. 1(3):223-8, 2008
Martínez-Lage JF et al: Acute cholecystitis complicating ventriculo-peritoneal shunting: report of a case and review of the literature. Childs Nerv Syst. 24(6):777-9, 2008
Nfonsam V et al: Laparoscopic management of distal ventriculoperitoneal shunt complications. Surg Endosc. 22(8):1866-70, 2008
Riffaud L et al: Acquired Chiari I malformation and syringomyelia after valveless lumboperitoneal shunt in infancy. Pediatr Neurosurg. 44(3):229-33, 2008
Liao YJ et al: Intracranial hypotension caused by leakage of cerebrospinal fluid from the thecal sac after lumboperitoneal shunt placement. Case report. J Neurosurg. 107(1):173-7, 2007
Tseng JS et al: Motor neuron disease-like syndrome secondary to trapped fourth ventricle and obstruction of cerebrospinal fluid pathway. Clin Neurol Neurosurg. 109(4):383-7, 2007
Woodworth G et al: Prior CSF shunting increases the risk of endoscopic third ventriculostomy failure in the treatment of obstructive hydrocephalus in adults. Neurol Res. 29(1):27-31, 2007
Di Rocco C et al: Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review. Childs Nerv Syst. 22(12):1573-89, 2006
Winston KR et al: CSF shunt failure with stable normal ventricular size. Pediatr Neurosurg. 42(3):151-5, 2006
Zamponi N et al: Bobble head doll syndrome in a child with a third ventricular cyst and hydrocephalus. Childs Nerv Syst. 21(5):350-4, 2005
Arnell K et al: Distal catheter obstruction from non-infectious cause in ventriculo-peritoneal shunted children. Eur J Pediatr Surg. 14(4):245-9, 2004
Blount JP et al: Sports and pediatric cerebrospinal fluid shunts: who can play? Neurosurgery. 54(5):1190-6; discussion 1196-8, 2004
Fewel ME et al: Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg. 100(2 Suppl Pediatrics):206-11, 2004
Hashimoto M et al: A case of abdominal CSF pseudocyst associated with silicone allergy. Childs Nerv Syst. 20(10):761-4, 2004
Sgouros S et al: An investigation of structural degradation of cerebrospinal fluid shunt valves performed using scanning electron microscopy and energy-dispersive x-ray microanalysis. J Neurosurg. 100(3):534-40, 2004
Tuli S et al: Predictors of death in pediatric patients requiring cerebrospinal fluid shunts. J Neurosurg. 100(5 Suppl Pediatrics):442-6, 2004
Villarejo FJ et al: Cerebral fluid edema: an unusual complication of ventriculoperitoneal shunts. Childs Nerv Syst. 20(3):195-8, 2004
Braun KP et al: 1H magnetic resonance spectroscopy in human hydrocephalus. J Magn Reson Imaging. 17(3):291-9, 2003
Krassoudakis A et al: Ventriculoperitoneal shunting complicated with cerebrospinal fluid pseudocyst and acute appendicitis. Minerva Pediatr. 54(4):321-3, 2002
Oh A et al: Laparoscopic repositioning of a ventriculo-peritoneal catheter tip for a sterile abdominal cerebrospinal fluid (CSF) pseudocyst. Surg Endosc. 15(5):518, 2001
Drake JM et al: CSF shunts 50 years on--past, present and future. Childs Nerv Syst. 16(10-11):800-4, 2000
Tuli S et al: Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg. 92(1):31-8, 2000
Lee TT et al: Unique clinical presentation of pediatric shunt malfunction. Pediatr Neurosurg. 30(3):122-6, 1999
Salomão JF et al: Abdominal pseudocysts complicating CSF shunting in infants and children. Report of 18 cases. Pediatr Neurosurg. 31(5):274-8, 1999
General term for enlargement of cerebral ventricles
Hydrocephalus (HCP)
Enlargement of cerebral ventricles secondary to abnormal CSF formation, flow, or absorption resulting in ↑ CSF volume
Subset of ventriculomegaly
Onset over days (acute), weeks (subacute), or months to years (chronic)
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Nonvascular Interventions
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Fowler JB et al: Ventriculoperitoneal shunt, 2020
Kaestner S et al: Revision surgery following CSF shunt insertion: how often could it be avoided? Acta Neurochir (Wien). 162(1):9-14, 2020
Mohammad SA et al: The value of CSF flow studies in the management of CSF disorders in children: a pictorial review. Insights Imaging. 10(1):3, 2019
Ezzat AAM et al: Migration of the distal catheter of ventriculoperitoneal shunts in pediatric age group: case series. World Neurosurg. 119:e131-7, 2018
Kraemer MR et al: Overdrainage-related ependymal bands: a postulated cause of proximal shunt obstruction. J Neurosurg Pediatr. 1-11, 2018
Ros B et al: Shunt overdrainage syndrome: review of the literature. Neurosurg Rev. 41(4):969-81, 2018
Hanak BW et al: Cerebrospinal fluid shunting complications in children. Pediatr Neurosurg. 52(6):381-400, 2017
Rinker EK et al: CSF shunt complications: what the abdominal imager needs to know. Abdom Imaging. 40(6):2030-40, 2015
Symss NP et al: Is there an ideal shunt? A panoramic view of 110 years in CSF diversions and shunt systems used for the treatment of hydrocephalus: from historical events to current trends. Childs Nerv Syst. 31(2):191-202, 2015
Koktekir E et al: Resolution of papilledema after endoscopic third ventriculostomy versus cerebrospinal fluid shunting in hydrocephalus: a comparative study. J Neurosurg. 120(6):1465-70, 2014
Bateman GA: Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt? J Neurosurg. 119(6):1503-10, 2013
Rasul FT et al: Is endoscopic third ventriculostomy superior to shunts in patients with non-communicating hydrocephalus? A systematic review and meta-analysis of the evidence. Acta Neurochir (Wien). 155(5):883-9, 2013
Symss NP et al: Theories of cerebrospinal fluid dynamics and hydrocephalus: historical trend. J Neurosurg Pediatr. 11(2):170-7, 2013
Robinson S: Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts. J Neurosurg Pediatr. 9(3):242-58, 2012
Sivaganesan A et al: Neuroimaging of ventriculoperitoneal shunt complications in children. Pediatr Radiol. 42(9):1029-46, 2012
Chan M et al: Prediction of ventriculoperitoneal shunt dependency in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg. 110(1):44-9, 2009
Peraud A et al: Decompensated hydrocephalus causing syringomyelia and tetraparesis: a case report. Childs Nerv Syst. 25(2):263-6, 2009
Willis B et al: Ventricular reservoirs and ventriculoperitoneal shunts for premature infants with posthemorrhagic hydrocephalus: an institutional experience. J Neurosurg Pediatr. 3(2):94-100, 2009
Dusick JR et al: Success and complication rates of endoscopic third ventriculostomy for adult hydrocephalus: a series of 108 patients. Surg Neurol. 69(1):5-15, 2008
Ellis MJ et al: Treatment of recurrent ventriculoperitoneal shunt failure associated with persistent cerebrospinal fluid eosinophilia and latex allergy by use of an "extracted" shunt. J Neurosurg Pediatr. 1(3):237-9, 2008
James HE et al: Management of complicated shunt infections: a clinical report. J Neurosurg Pediatr. 1(3):223-8, 2008
Martínez-Lage JF et al: Acute cholecystitis complicating ventriculo-peritoneal shunting: report of a case and review of the literature. Childs Nerv Syst. 24(6):777-9, 2008
Nfonsam V et al: Laparoscopic management of distal ventriculoperitoneal shunt complications. Surg Endosc. 22(8):1866-70, 2008
Riffaud L et al: Acquired Chiari I malformation and syringomyelia after valveless lumboperitoneal shunt in infancy. Pediatr Neurosurg. 44(3):229-33, 2008
Liao YJ et al: Intracranial hypotension caused by leakage of cerebrospinal fluid from the thecal sac after lumboperitoneal shunt placement. Case report. J Neurosurg. 107(1):173-7, 2007
Tseng JS et al: Motor neuron disease-like syndrome secondary to trapped fourth ventricle and obstruction of cerebrospinal fluid pathway. Clin Neurol Neurosurg. 109(4):383-7, 2007
Woodworth G et al: Prior CSF shunting increases the risk of endoscopic third ventriculostomy failure in the treatment of obstructive hydrocephalus in adults. Neurol Res. 29(1):27-31, 2007
Di Rocco C et al: Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review. Childs Nerv Syst. 22(12):1573-89, 2006
Winston KR et al: CSF shunt failure with stable normal ventricular size. Pediatr Neurosurg. 42(3):151-5, 2006
Zamponi N et al: Bobble head doll syndrome in a child with a third ventricular cyst and hydrocephalus. Childs Nerv Syst. 21(5):350-4, 2005
Arnell K et al: Distal catheter obstruction from non-infectious cause in ventriculo-peritoneal shunted children. Eur J Pediatr Surg. 14(4):245-9, 2004
Blount JP et al: Sports and pediatric cerebrospinal fluid shunts: who can play? Neurosurgery. 54(5):1190-6; discussion 1196-8, 2004
Fewel ME et al: Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg. 100(2 Suppl Pediatrics):206-11, 2004
Hashimoto M et al: A case of abdominal CSF pseudocyst associated with silicone allergy. Childs Nerv Syst. 20(10):761-4, 2004
Sgouros S et al: An investigation of structural degradation of cerebrospinal fluid shunt valves performed using scanning electron microscopy and energy-dispersive x-ray microanalysis. J Neurosurg. 100(3):534-40, 2004
Tuli S et al: Predictors of death in pediatric patients requiring cerebrospinal fluid shunts. J Neurosurg. 100(5 Suppl Pediatrics):442-6, 2004
Villarejo FJ et al: Cerebral fluid edema: an unusual complication of ventriculoperitoneal shunts. Childs Nerv Syst. 20(3):195-8, 2004
Braun KP et al: 1H magnetic resonance spectroscopy in human hydrocephalus. J Magn Reson Imaging. 17(3):291-9, 2003
Krassoudakis A et al: Ventriculoperitoneal shunting complicated with cerebrospinal fluid pseudocyst and acute appendicitis. Minerva Pediatr. 54(4):321-3, 2002
Oh A et al: Laparoscopic repositioning of a ventriculo-peritoneal catheter tip for a sterile abdominal cerebrospinal fluid (CSF) pseudocyst. Surg Endosc. 15(5):518, 2001
Drake JM et al: CSF shunts 50 years on--past, present and future. Childs Nerv Syst. 16(10-11):800-4, 2000
Tuli S et al: Risk factors for repeated cerebrospinal shunt failures in pediatric patients with hydrocephalus. J Neurosurg. 92(1):31-8, 2000
Lee TT et al: Unique clinical presentation of pediatric shunt malfunction. Pediatr Neurosurg. 30(3):122-6, 1999
Salomão JF et al: Abdominal pseudocysts complicating CSF shunting in infants and children. Report of 18 cases. Pediatr Neurosurg. 31(5):274-8, 1999
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