A critical analysis of 'normal' radionucleotide shuntograms in patients subsequently requiring surgery

D. F. O'Brien, M. Taylor, T. S. Park, J. G. Ojemann

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Background: Shuntograms are performed when patients present with symptoms suggestive of, but inconclusive for, shunt malfunction, without confirmatory radiological evidence. Methods: Shuntograms over the past 3.5 years were reviewed. Patient records were reviewed for revision in proximity to a negative (normal) study. Results: One hundred and fifteen out of 149 tests were negative. Thirty-four surgeries (in 31 patients) occurred subsequent to a negative shuntogram. In 18 out of 34 revisions the shunt was functional: 13 surgeries were for overdrainage, 4 were for unrelated reasons with shunt function confirmed incidentally and 1 was an exploration for cognitive deterioration. In 16 cases (13 patients) the shunt was not functional: 12 had proximal catheter occlusion in which, on subsequent review, there was no ventricular reflux present and the remaining had distal malfunctions. Conclusions: The false negative rate for shuntograms was 16 out of 115 (14%) with proximal occlusion most common. This estimate of the predictive value of a normal flow study may influence the decision to revise a shunt.

Original languageEnglish
Pages (from-to)337-341
Number of pages5
JournalChild's Nervous System
Volume19
Issue number5-6
DOIs
StatePublished - Jun 1 2003

Keywords

  • Decision-making
  • Hydrocephalus
  • Overdrainage
  • Shunt malfunction
  • Slit ventricle syndrome

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