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Subcutaneously obstructed ventriculoperitoneal shuntogram.

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  • 1From the *Department of Radiology, University of Washington, Seattle, WA; †Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY; ‡IRCCS Fondazione SDN, Naples; and §Dipartimento di Radiologia, Università degli Studi di Firenze, Florence, Italy.

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A radionuclide shuntogram revealed an unusual cause of hydrocephalus in a patient with a recently revised ventriculoperitoneal (VP) shunt, highlighting the diagnostic value of this imaging technique.

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Area of Science:

  • Neurosurgery
  • Radiology
  • Nuclear Medicine

Background:

  • Hydrocephalus management often involves ventriculoperitoneal (VP) shunts.
  • Shunt malfunction can lead to neurological complications.
  • Accurate diagnosis of shunt dysfunction is critical for patient outcomes.

Observation:

  • A 65-year-old male presented with headache, altered mental status, and somnolence.
  • A recent ventriculoperitoneal (VP) shunt revision was noted.
  • Head CT revealed interval hydrocephalus compared to pre-revision imaging.

Findings:

  • A radionuclide shuntogram using 99mTcO4 was performed to assess VP shunt dynamics.
  • The shuntogram confirmed radiotracer passage through the VP shunt tubing.
  • This indicated a functional shunt but an atypical cause for hydrocephalus.

Implications:

  • Radionuclide shuntography is a valuable tool for evaluating VP shunt function.
  • It can identify unusual etiologies of hydrocephalus post-shunting.
  • This case underscores the importance of comprehensive diagnostic approaches in shunt management.