Clinical diagnosis of ventriculoperitoneal shunt failure among children with hydrocephalus

Pediatric Emergency Care
Joseph H Piatt, Hugh J L Garton

Abstract

To define the significance of various symptoms and signs in the diagnosis of ventriculoperitoneal shunt failure and infection. The observations that form the basis of this study were made in the course of 2 multicenter, prospective, randomized, controlled clinical trials of technical aspects of ventriculoperitoneal shunt surgery-the Shunt Design Trial and the Endoscopic Shunt Insertion Trial. At registration, basic demographic and baseline clinical data were recorded. At scheduled follow-up visits 3 months and 1, 2, and 3 years after surgery and at unscheduled visits, the presence or absence of various symptoms or signs was recorded. At each visit, the neurosurgeon-investigator made a determination about whether the shunt had reached an end point: mechanical obstruction, infection, overdrainage, or loculation of the ventricular system. Observations at the last follow-up visit for each patient constituted the data for the current study. Sensitivities, specificities, and likelihood ratios were calculated for each symptom and sign as tests for shunt failure from any cause and for failure by infection. Decision trees were constructed to analyze the relationships of various symptoms and signs in the diagnosis of shunt failure and in...Continue Reading

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Citations

Feb 11, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Mehmet YamanErkan Kaptanoglu
Jan 9, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Farid KhanMuhammad Ehsan Bari
Nov 22, 2008·Indian Journal of Pediatrics·A N GangopadhyayS P Sharma
Apr 26, 2012·Pediatric Emergency Care·Elisabeth Ashley RogersMark I Neuman
Jul 7, 2012·Pediatric Emergency Care·Leah Marion Hamburg, David O Kessler
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Jan 9, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Altan GunesSahin Hanalioglu
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Jun 7, 2019·Journal of Child Neurology·Eugene Kim, Giovanni Cucchiaro
Jul 4, 2021·Emergency Medicine Clinics of North America·Alamelu Natesan, Solomon Behar

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