CSF shunt complications: what the abdominal imager needs to know

Abstract

Cerebrospinal fluid (CSF) shunting has been a mainstay in the treatment of hydrocephalus for many decades. With a reported 33,000 shunt placement procedures performed in the US annually, and a lifetime revision rate approaching 50%, abdominal radiologists must be familiar with the typical imaging appearance of an array of shunt complications. Complications related to the peritoneal portion of the shunt have been reported in up to 25% of patients. We present a comprehensive pictorial essay including computed tomography, conventional radiography, ultrasound, and nuclear medicine examples illustrating abdominal complications related to CSF shunting and a review of the current literature. The purpose of this pictorial essay is to provide multimodality imaging examples of CSF shunt complications and familiarize the abdominal imager with the spectrum of findings.

Impact of Hospital Volume on Outcome After Surgical Treatment for Hydrocephalus: A U.S. Population Study From the National Inpatient Sample

“…Regardless of disease etiology, the treatment of hydrocephalus by shunting remains a common strategy. Prior studies have suggested that CSF diversion procedures account for $2-8 billion annually of hospital costs in the U.S. [2,3] Even with modern biomedical advancements in shunts that increase favorable outcomes, half of all ventricular shunts require revision in the first year, resulting in more surgical procedures with a higher risk of complications [4][5][6][7]. Despite how common hydrocephalus is among neurosurgery patients, there is insufficient analysis in the literature of the epidemiology of shunted hydrocephalus as well as the impact of hospital volume on outcomes.…”

Ventriculoperitoneal Shunt: Impact of Nursing Management on Outcomes of Patients with Adult Hydrocephalus

“…Regardless the high rate of ventriculoperitoneal shunt complications, it stills the mainstay of management for hydrocephalus. Shunt malfunction, shunt infection, over drainage, under drainage, peritonitis, hernia, lost distal catheter, bowel perforation and subdural hematoma all are complications of ventriculoperitoneal shunt (Rinker et al, 2015).…”

In-vitro Performance verschiedener Kombinationen von verstellbaren Differenzdruckventilen mit fixen Anti-Siphon-Devices unter Berücksichtigung der räumlichen Position

“…Weiterhin können Shunts in das Hirnparenchym, den Plexus choroideus oder ins subkutane Fettgewebe fehlplatziert werden. Es ist möglich, dass die einzelnen Shuntkomponenten diskonnektieren oder Materialbrüche entstehen (Rinker et al 2015;Hanak et al 2017). In 0,7-4,0 % der Fälle entwickeln sich Pseudozysten im Abdomen, die die Liquorresorption des Peritoneums behindern (Pernas und Catala 2004;Chick et al 2013;Bober et al 2016).…”

“…In 0,7-4,0 % der Fälle entwickeln sich Pseudozysten im Abdomen, die die Liquorresorption des Peritoneums behindern (Pernas und Catala 2004;Chick et al 2013;Bober et al 2016). Sehr selten bilden sich Kalkablagerungen im Shunt (Rinker et al 2015;Salim et al 2015).…”