Investigating shunt function using continuous intracranial pressure monitoring in adults: single center experience.
OBJECTIVE
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.
Toma
Ahmed K
AK
Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom. Ahmedktoma@yahoo.com
Tarnaris
Andrew
A
Kitchen
Neil D
ND
Watkins
Laurence D
LD
D000328:Adult; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects