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Related Experiment Videos

Pumping the shunt revisited. A longitudinal study

J H Piatt1

  • 1Division of Neurosurgery (L472), Oregon Health Sciences University, Portland 97201-3098, USA.

Pediatric Neurosurgery
|August 1, 1996
PubMed
Summary
This summary is machine-generated.

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Changes in cerebrospinal fluid (CSF) shunt pumping over time do not reliably indicate shunt malfunction in hydrocephalus patients. This interval shunt pumping test is not sensitive enough to rule out or confirm malfunction.

Area of Science:

  • Neurosurgery
  • Pediatric Neurosurgery
  • Biomedical Engineering

Background:

  • Cerebrospinal fluid (CSF) shunts with integrated pumps are used to treat hydrocephalus.
  • Shunt pump characteristics are sometimes used clinically to assess shunt function.
  • Previous studies show poor correlation between single-point shunt function tests and clinical status.

Purpose of the Study:

  • To determine if longitudinal changes in shunt pumping characteristics correlate with clinical status changes in pediatric hydrocephalus patients.
  • To evaluate the diagnostic accuracy of interval changes in shunt pumping for detecting shunt malfunction.

Main Methods:

  • A longitudinal study involving 115 pediatric patients with CSF shunts.
  • Patients were assessed at least twice by a single pediatric neurosurgeon.

Related Experiment Videos

  • Shunt pumping characteristics and clinical status were monitored over time; malfunction was confirmed by neuroimaging and surgery.

    • Main Results:

    • 10 out of 115 patients had confirmed symptomatic shunt malfunction at the second examination.
    • The interval shunt pumping test showed a sensitivity of 0.50 and specificity of 0.64.
    • Negative predictive value was 0.93, but positive predictive value was only 0.12.

    Conclusions:

    • The interval shunt pumping test is not sufficiently sensitive to reliably rule out CSF shunt malfunction.
    • A positive result from the interval shunt pumping test in asymptomatic patients does not warrant further expensive investigations.