Abstract
This chapter reviews the diagnostic imaging findings related to the procedures and devices used for managing cerebrospinal fluid diversion, including external ventricular drains, ventriculoperitoneal shunts, atypical ventricular shunts, ventriculosubgaleal shunts, ventriculo-cisternal shunts, percutaneously accessed cerebrospinal fluid reservoirs, subduralperitoneal shunts, cystoperitoneal and cystoventriculostomy shunts. cystoperitoneal and cystoventriculostomy shunts, cystoperitoneal and cystoventriculostomy shunts, third ventriculocisternostomy, endoscopic septum pellucidum and intraventricular cyst fenestration, aqueductoplasty, endoscopic choroid plexus cauterization, complications related to cerebrospinal fluid diversion surgeries, and Chiari decompression surgery and associated complications.
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Types of Procedures
External Ventricular Drainage
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Ventriculoperitoneal Shunts
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Atypical Ventricular Shunts
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Ventriculosubgaleal Shunts
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Ventriculo-Cisternal (Torkildsen) Shunts
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Percutaneously Accessed Cerebrospinal Fluid Reservoirs
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Subdural-Peritoneal Shunts
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Cystoperitoneal and Cystoventriculostomy Shunts
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Syringosubarachnoid and Syringopleural Shunts
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Lumboperitoneal Shunt
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Third Ventriculostomy
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Endoscopic Septum Pellucidum and Cyst Fenestration
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Aqueductoplasty
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Endoscopic Choroid Plexus Cauterization
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Pople IK, Ettles D (1995) The role of endoscopic choroid plexus coagulation in the management of hydrocephalus. Neurosurgery 36(4):698–701; discussion 701–702
Fourth Ventricular Stenting
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Complications
Corpus Callosum Changes Secondary to Shunt Catheterization
Lane JI, Luetmer PH, Atkinson JL (2001) Corpus callosal signal changes in patients with obstructive hydrocephalus after ventriculoperitoneal shunting. AJNR Am J Neuroradiol 22(1):158–162
Numaguchi Y, Kristt DA, Joy C, Robinson WL (1993) Scalloping deformity of the corpus callosum following ventricular shunting. AJNR Am J Neuroradiol 14(2):355–362
Shunt-Associated Intracranial Hemorrhage and Gliosis
Fukuhara T, Vorster SJ, Luciano MG (2000) Critical shunt-induced subdural hematoma treated with combined pressure-programmable valve implantation and endoscopic third ventriculostomy. Pediatr Neurosurg 33(1):37–42
Misaki K, Uchiyama N, Hayashi Y, Hamada J (2010) Intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion - four case reports. Neurol Med Chir (Tokyo) 50(1):76–79
Savitz MH, Bobroff LM (1999) Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion. J Neurosurg 91(1):32–34
Sharma RR, Mahapatra A, Pawar SJ, Sousa J, Athale SD. Symptomatic calcified subdural hematomas. Pediatr Neurosurg 1999;31(3):150–154.
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Intraventricular Fat Migration
Goeser CD, McLeary MS, Young LW (1998) Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics 18(3):635–651
MRI-Induced Programmable Valve Setting Alteration
Lavinio A, Harding S, Van Der Boogaard F, Czosnyka M, Smielewski P, Richards HK, Pickard JD, Czosnyka ZH (2008) Magnetic field interactions in adjustable hydrocephalus shunts. J Neurosurg Pediatr 2(3): 222–228
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Murtagh FR, Quencer RM, Poole CA (1979) Cerebrospinal fluid shunt function and hydrocephalus in the pediatric age group: a radiographic/clinical correlation. Radiology 132(2):385–388
Ventricular Loculations and Isolated Ventricles
Hubbard JL, Houser OW, Laws ER Jr (1987) Trapped fourth ventricle in an adult: radiographic findings and surgical treatment. Surg Neurol 28(4):301–306
Maurice-Williams RS, Choksey M (1986) Entrapment of the temporal horn: a form of focal obstructive hydrocephalus. J Neurol Neurosurg Psychiatry 49(3): 238–242
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Slit Ventricle Syndrome
Goeser CD, McLeary MS, Young LW (1998) Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics 8(3):635–651
Rekate HL (2008) Shunt-related headaches: the slit ventricle syndromes. Childs Nerv Syst 24(4):423–430
Chronic Overshunting and Associated Findings
Di Preta JA, Powers JM, Hicks DG (1994) Hyperostosis cranii ex vacuo: a rare complication of shunting for hydrocephalus. Hum Pathol 25(5):545–547
Hochman MS, Naidich TP (1999) Diffuse meningeal enhancement in patients with overdraining, longstanding ventricular shunts. Neurology 52(2): 406–409
Lucey BP, March GP Jr, Hutchins GM (2003) Marked calvarial thickening and dural changes following chronic ventricular shunting for shaken baby syndrome. Arch Pathol Lab Med 127(1):94–97
Seyithanoglu H, Guzey FK, Emel E, Ozkan N, Aycan A (2010) Chronic ossified epidural hematoma after ventriculoperitoneal shunt insertion: a case report. Turk Neurosurg 20(4):519–523
Vinchon M, Dhellemmes P, Laureau E, Soto-Ares G (2007) Progressive myelopathy due to meningeal thickening in shunted patients: description of a novel entity and the role of surgery. Childs Nerv Syst 23(8):839–845
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Shunt-Associated Infections
Goeser CD, McLeary MS, Young LW (1998) Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics 18(3):635–651
Puca A, Anile C, Maira G, Rossi G (1991) Cerebrospinal fluid shunting for hydrocephalus in the adult: factors related to shunt revision. Neurosurgery 29(6):822–826
Shunt Malposition and Migration
Alakandy LM, Iyer RV, Golash A (2008) Hemichorea, an unusual complication of ventriculoperitoneal shunt. J Clin Neurosci 15(5):599–601
Ghritlaharey RK, Budhwani KS, Shrivastava DK, Gupta G, Kushwaha AS, Chanchlani R, Nanda M (2007) Trans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in children. Pediatr Surg Int 23(6):575–580
Sathyanarayana S, Wylen EL, Baskaya MK, Nanda A (2000) Spontaneous bowel perforation after ventricu-loperitoneal shunt surgery: case report and a review of 45 cases. Surg Neurol 54(5):388–396
Wan KR, Toy JA, Wolfe R, Danks A (2011) Factors affecting the accuracy of ventricular catheter placement. J Clin Neurosci 18(4):485–488
Shunt Catheter Disconnection and Retained Fragments
Boch AL, Hermelin E, Sainte-Rose C, Sgouros S (1998) Mechanical dysfunction of ventriculoperitoneal shunts caused by calcification of the silicone rubber catheter. J Neurosurg 88(6):975–982
Goeser CD, McLeary MS, Young LW (1998) Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics 18(3):635–651
Intraparenchymal Pericatheter Cysts and Interstitial Cerebrospinal Fluid
Iqbal J, Hassounah M, Sheikh B (2000) Intraparenchymal pericatheter cyst. A rare complication of ventriculo-peritoneal shunt for hydrocephalus. Br J Neurosurg 14(3):255–258
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Pseudocysts
Chung JJ, Yu JS, Kim JH, Nam SJ, Kim MJ (2009) Intraabdominal complications secondary to ventriculoperitoneal shunts: CT findings and review of the literature. AJR Am J Roentgenol 193(5):1311–1317
Goeser CD, McLeary MS, Young LW (1998) Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics 18(3):635–651
Kariyattil R, Steinbok P, Singhal A, Cochrane DD (2007) Ascites and abdominal pseudocysts following ventriculoperitoneal shunt surgery: variations of the same theme. J Neurosurg 106(5 Suppl):350–353
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Cerebrospinal Fluid Leak Syndrome
Liao YJ, Dillon WP, Chin CT, McDermott MW, Horton JC (2007) Intracranial hypotension caused by leakage of cerebrospinal fluid from the thecal sac after lumbo-peritoneal shunt placement. Case report. J Neurosurg 107(1): 173–177
Tumor Seeding
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Shunt Catheter Calcifications
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Pulmonary Embolism from Ventriculoatrial Shunting
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Chiari Decompression Surgery and Associated Complications
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Ginat, D.T., Westesson, PL.A., Frim, D. (2017). Imaging of Cerebrospinal Fluid Shunts, Drains, and Diversion Techniques. In: Ginat, D., Westesson, PL. (eds) Atlas of Postsurgical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-52341-5_6
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