Comparison of ventricular drain location and infusion test in hydrocephalus
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Authors
Sinha, Rohitashwa
Morgan, James AD
Wawrzynski, James R
Czosnyka, Zofia
Kasprowicz, Magdalena
Garnett, Matthew
Hutchinson, Peter John
Publication Date
2016-03-29Journal Title
Acta Neurologica Scandinavica
Publisher
Wiley-Blackwell
Language
English
Type
Article
Metadata
Show full item recordCitation
Sinha, R., Morgan, J. A., Wawrzynski, J. R., Czosnyka, Z., Kasprowicz, M., Czosnyka, M., Garnett, M., et al. (2016). Comparison of ventricular drain location and infusion test in hydrocephalus. Acta Neurologica Scandinavica https://doi.org/10.17863/CAM.10441
Abstract
OBJECTIVES: Suspected cerebrospinal fluid shunt (CSF) dysfunction in hydrocephalic patients poses a diagnostic uncertainty. The clinical picture can be non-specific and CT imaging alone is not always pathognomonic. Infusion tests are an increasingly used investigation for real-time hydrodynamic assessment of shunt patency. We report the correlation between infusion test results with the quality of ventricular drain placement on CT scans in a large retrospective group of hydrocephalic patients. MATERIALS & METHODS: Three hundred and six infusion test results performed in 200 patients were correlated with 306 corresponding CT head scans. Nominal logistic regression was used to correlate shunt catheter position on CT imaging to patency of ventricular drain as determined by infusion tests. RESULTS: Infusion test results of shunt patency are statistically congruent with the analysis of shunt catheter position on CT head scans. Catheter tips completely surrounded by either parenchyma or CSF on CT imaging are strongly associated with evidence of occlusion or patency from infusion tests, respectively (χ² = 51.68, P < 0.0001, n = 306 and χ² = 31.04, P < 0.0001, n = 306). CONCLUSIONS: The most important anatomical factor for shunt patency is the catheter tip being completely surrounded by CSF. Infusion tests provide functional and reliable assessment of shunt patency in vivo and are strongly correlated with the position of the ventricular catheter on CT imaging.
Keywords
infusion test, ventriculoperitoneal shunts, hydrocephalus
Sponsorship
No funding source.
Funder references
MRC (G0600986)
MRC (G9439390)
Identifiers
This record's DOI: https://doi.org/10.17863/CAM.10441
This record's URL: https://www.repository.cam.ac.uk/handle/1810/266099
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