Main findings and complications after the placement of CSF shunts: the keys to a brilliant radiological diagnosis

Congress:

ECR 2024

Poster Number:

C-15142

Type:

Educational Exhibit

Keywords:

Emergency, Neuroradiology brain, Conventional radiography, CT, Ultrasound, Complications, Shunts, Surgery, Cerebrospinal fluid

Authors:

A. S. Gabín, S. Revuelta Gómez, A. Somoano, R. Sutil, A. Berasategui Criado, M. Arroyo Olmedo, M. J. Galante Mulki, M. Drake Perez

DOI:

10.26044/ecr2024/C-15142

DOI-Link:

https://dx.doi.org/10.26044/ecr2024/C-15142

Learning objectives

To understand the basic components of a CSF shunt. To review the findings that could be expected by imaging after the implantation of a CSF shunt system. To describe the main complications that we could observed as radiologists in imaging tests.

Background

The main characteristics of ventricular shunt systems from the imaging point of view are reviewed in the literature. We analize its most frequent complications, both in the immediate post-surgical period and in the medium and long term. Likewise, we provide representative examples that help us to understand in a visual way each of them.

Findings and procedure details

BASIC COMPONENTS OF CSF SHUNTSHydrocephalus is a term used to describe different conditions involving accumulation of different fluids in the intracranial ventricular system. Over the last decades, ventricular shunts, whose function is to "carry" this excess fluid to an alternative anatomical cavity, have become established as the main treatment for hydrocephalus.In order to understand the complications that can arise after their implantation, it is interesting to know first of all what components can be found in a shunt system under normal conditions and what their...

Conclusion

The radiologist must be familiar with the main imaging findings after the implantation of a CSF shunt system, in order to be able to suspect, and eventually diagnose, possible complications related to them.

Personal information and conflict of interest

A. S. Gabín: Nothing to disclose S. Revuelta Gómez: Nothing to disclose A. Somoano: Nothing to disclose R. Sutil: Nothing to disclose A. Berasategui Criado: Nothing to disclose M. Arroyo Olmedo: Nothing to disclose M. J. Galante Mulki: Nothing to disclose M. Drake Perez: Nothing to disclose

References

Wallace, A. N., McConathy, J., Menias, C. O., Bhalla, S., & Wippold, F. J. (2014). Imaging evaluation of CSF shunts.American Journal of Roentgenology,202(1), 38-53. Sellin, J. N., Cherian, J., Barry, J. M., Ryan, S. L., Luerssen, T. G., & Jea, A. (2014). Utility of computed tomography or magnetic resonance imaging evaluation of ventricular morphology in suspected cerebrospinal fluid shunt malfunction.Journal of Neurosurgery: Pediatrics,14(2), 160-166. Morone, P. J., Dewan, M. C., Zuckerman, S. L., Tubbs, R. S., & Singer, R. J. (2020). Craniometrics and ventricular access:...

Fig 1: Figure 1: The first image (a) shows the Kocher point, one of the most commonly...

Fig 2: Figure 2: Normal ventriculoperitoneal shunt placement. (a) Lateral radiograph...

Fig 3: Figure 3: outline of the main complications of ventricular shunts.

Fig 4: Figure 4: (a) Patient with known coagulation disorders, who presented...

Fig 5: Figure 5: (a) Increase in ventricular size in a patient with...

Fig 6: Figure 6: Patient with a ventriculo-peritoneal shunt presenting to the...

Fig 7: Figure 7: (a) Normal post-surgical control CT scan of patient with ventricular...

Fig 8: Figure 8: (a) Patient with ventricular shunt, who came to the emergency...

Fig 9: Figure 9: (a) Axial MRI in T1 sequence with contrast, showing uptake of the...

Fig 10: Figure 10: (a) Patient who developed an isolated IV ventricle after...

Fig 11: Figure 11: (a) Simple abdominal X-ray with distal catheter with end in the...

Fig 12: Figure 12: (a) MRI in coronal T1 sequence showing soft tissue alteration...