The Significance of Continuous CSF Measurement in Suspected Shunt Dysfunction

Summary From 1981 to September 1983, 72 continuous CSF meas urements were performed on 65 children with suspected shunt dysfunction. The pressure was 21 times > 180 (Group I), 7 times 135-180 (Group 2) and 44 times < 135 mmHp (Group 3). Shunt revision seemed indicated in all of Group I, in 4 of Group 2 and in 3 of Group 3. The 28 children operated on following manometry amount to 46 % 01' all patients revised during the same time. Headache, vomiting, some neurological and non-specific signs were like wise observed in all 3 groups. The palpable valve function was only exceptionally abnormal in Group I, but abnormal in 113 in Group 3. The shunt function was finally evaluated in Group I to 3 as folIows: 39 % shunt revision indicated, 30.5 % functioning shunt, 19.5 % temporary or intermittent shunt dysfunction, 10% temporary oIigoliquorrhea (overdrainage). 1% arrested hydrocephalus. The accuracy of the judgment was confirmed in all but 4 by follow-ups; in proximal occlu sion, CSF leakages an multiple shunts, seemingly normal CSF , pressure values may be obtained (10% ofall measurements).