Determination of cerebrospinal fluid shunt function with water-soluble contrast medium

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Abstract
Determination of CSF shunt patency with water-soluble contrast medium is a simple, rapid, reliable and safe technique. Since Sept. 1974, 113 examinations were performed. With the Spitz-Holter valve, only the atrial catheter can be studied, but with the Pudenz valve and with the shunting devices that have a double-dome reservoir, both the proximal and the distal catheter can be visualized. Through the ventricular catheter a full ventriculographic study can be made, demonstrating ventricular size, malposition of the catheter and the lesion that caused the hydrocephalus or its development. The problem of collapsed ventricles, in which clinical and manual evaluation of the flushing device can give misleading findings, is emphasized. The injection of the atrial or peritoneal catheter in the pathological cases demonstrated its blockage, level of disconnection, malposition, sleeve or cyst formation. Computerized tomography has only slightly decreased the number of these studies. When the ventricles are large, the examination with water-soluble contrast medium is still needed to demonstrate the exact level of malfunction. This demonstration has decreased the number of the total revisions or complete changes of shunting systems, eliminating some unnecessary changes of normally functioning catheters.