{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:16:54Z","timestamp":1785554214514,"version":"3.56.0"},"reference-count":8,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,6,1]]},"abstract":"<jats:p>Introduction.\u2003The diagnosis of shunt malfunction can be difficult even for the experienced clinician and may lead to disastrous circumstances when misinterpreted. Less experienced physicians may rely more on radiographic reports as a primary diagnostic modality. In this study, we evaluated the reliability of using these reports without accurate clinical assessment.<\/jats:p>\n               <jats:p>Methods.\u2003All shunt revisions seen at Children's Hospital (Birmingham, AL) between January 1996 and August 1996 were reviewed, excluding patients with brain tumors, supratentorial extraaxial fluid collections, and infections. Sixty-eight patients underwent 100 operations for shunt malfunction. All patients had evidence of shunt blockage, disconnection, catheter malposition, or valve pressure incompatibility. The prospective radiographic interpretation of preoperative computed tomography and magnetic resonance imaging scans was reviewed in each case.<\/jats:p>\n               <jats:p>Results.\u2003Twenty-four percent of the reports made no mention of shunt malfunction. In this group, the ventricular system was described as \u201cunchanged,\u201d \u201cstable,\u201d \u201cnormal,\u201d \u201cunremarkable,\u201d \u201csmall,\u201d \u201csmaller,\u201d \u201cslit,\u201d \u201cnegative,\u201d and \u201cno hydrocephalus,\u201d with no other comment to support a diagnosis of shunt malfunction. An additional 9% of reports contained the same terms, while also hinting at some other clinical or radiographic data that suggest the possibility of shunt failure (eg, a shunt disconnection seen on plain radiographs), despite the scan findings. In all patients in this group, symptoms improved after surgery.<\/jats:p>\n               <jats:p>Conclusion.\u2003We conclude that as many as one third of patients presenting with shunt malfunction will not have the diagnosis of shunt malfunction supported by a prospective radiologic interpretation of brain imaging. Although the neurosurgical community can assess the clinical situation to determine the need for surgery, other clinicians can be easily reassured by a radiographic report that does not mention or diagnose shunt malfunction. Today, more than ever, nonneurosurgeons are being called on to evaluate complex clinical situations and may rely on radiographic reports.<\/jats:p>","DOI":"10.1542\/peds.101.6.1031","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:44:32Z","timestamp":1092440672000},"page":"1031-1036","source":"Crossref","is-referenced-by-count":82,"title":["Pitfalls in the Diagnosis of Ventricular Shunt Dysfunction: Radiology Reports and Ventricular Size"],"prefix":"10.1542","volume":"101","author":[{"given":"Bermans J.","family":"Iskandar","sequence":"first","affiliation":[{"name":"From the Departments of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy B.","family":"Mapstone","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Grabb","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatric Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Jerry","family":"Oakes","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatric Neurosurgery and"},{"name":"Pediatrics, Division of Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,6,1]]},"reference":[{"key":"2021121000194896300_B1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/BF00706687","article-title":"Spectrum of benign intracranial hypertension in children and adolescents.","volume":"1","author":"Amacher","year":"1985","journal-title":"Child Nerv Syst"},{"key":"2021121000194896300_B2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.3171\/jns.1987.67.4.0535","article-title":"Relationships between intracranial pressure, ventricular size, and resistance to CSF outflow.","volume":"67","author":"Borgesen","year":"1987","journal-title":"J Neurosurg"},{"key":"2021121000194896300_B3","doi-asserted-by":"crossref","first-page":"211","DOI":"10.3171\/jns.1986.65.2.0211","article-title":"Subtle deterioration in shunted childhood hydrocephalus. A biomechanical and clinical profile.","volume":"65","author":"Fried","year":"1986","journal-title":"J Neurosurg"},{"key":"2021121000194896300_B4","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1227\/00006123-197911000-00001","article-title":"Increased intraventricular pressure without ventriculomegaly in children with shunts: \u201cnormal volume\u201d hydrocephalus.","volume":"5","author":"Engel","year":"1979","journal-title":"Neurosurgery"},{"key":"2021121000194896300_B5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/BF00706807","article-title":"Morphological findings of postshunt slit-ventricle in experimental canine hydrocephalus. Aspects of causative factors of isolated ventricles and slit-ventricle syndrome.","volume":"2","author":"Oi","year":"1986","journal-title":"Child Nerv Syst"},{"key":"2021121000194896300_B6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3171\/jns.1985.63.1.0069","article-title":"Biomechanical and hydrodynamic characterization of the hydrocephalic infant.","volume":"63","author":"Shapiro","year":"1985","journal-title":"J Neurosurg"},{"key":"2021121000194896300_B7","doi-asserted-by":"crossref","first-page":"697","DOI":"10.2214\/ajr.150.3.697","article-title":"The value of reading the previous radiology report.","volume":"150","author":"Hunter","year":"1988","journal-title":"AJR Am J Roentgenol"},{"key":"2021121000194896300_B8","doi-asserted-by":"crossref","first-page":"803","DOI":"10.2214\/ajr.165.4.7676970","article-title":"Radiology reports: how much descriptive detail is enough?","volume":"165","author":"McLoughlin","year":"1995","journal-title":"AJR Am J Roentgenol"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/6\/1031\/886360\/pe069801031o.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/101\/6\/1031\/886360\/pe069801031o.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T06:56:42Z","timestamp":1639119402000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/101\/6\/1031\/61765\/Pitfalls-in-the-Diagnosis-of-Ventricular-Shunt"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,6,1]]},"references-count":8,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1998,6,1]]},"published-print":{"date-parts":[[1998,6,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.101.6.1031","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1998,6,1]]}}}