Cerebrospinal shunt flow in adults: radionuclide quantitation with emphasis on patient position.

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Abstract
Radionuclide quantitation of CSF flow through a ventricular shunt using a Cordis-Hakim valve was performed in 78 adults (138 studies). All remained supine for at least 3 h before the study to avoid possible depletion of ventricular CSF. The absolute flow rate distinguished shunt adequacy from patency by defining flow of < 0.1 ml/min as abnormal. Measurements were performed with the patient first supine and then erect. When abnormal supine flow was the criterion of malfunction, all obstructions were detected but there were 6 false positives. When abnormal erect flow was considered, there were 5 false negatives. Abnormal flow in both supine and erect positions is a reliable indication of malfunction. This technique is valuable for neurosurgical management of ventricular shunts.