{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:06:30Z","timestamp":1776096390343,"version":"3.50.1"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"7","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,2,16]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Phase-contrast MRI (PC-MRI) offers a rapid, noninvasive technique to directly quantify flow through ventricular shunts, and it serves as an adjunct MRI sequence to inform decision-making in complex postoperative settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 19-year-old man with Dandy-Walker\u2013associated hydrocephalus underwent proximal catheter exchange of a right-sided parietal ventriculoperitoneal shunt. Postoperatively, he developed intraventricular hemorrhage and symptomatic shunt occlusion and required emergency left frontal external ventricular drain (EVD) placement. After 5 days of drainage, the EVD was clamped and limited brain MRI with PC-MRI was performed. Shunt flow measured 21.2 \u00b1 2.8 mL\/hr, exceeding the patient\u2019s prior mean EVD output of 12 \u00b1 6.8 mL\/hr. The lateral ventricles had returned to their presymptomatic size, and the patient\u2019s symptoms resolved. These concordant findings supported shunt patency, enabling safe EVD removal, and no additional shunt surgery was required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>When ventricular size, pressure, and clinical status alone cannot conclusively establish ventricular shunt function, PC-MRI can supply a direct, quantitative measure of CSF flow. Incorporating this brief (60-second) sequence into surveillance imaging for patients with ventricular shunts may refine management decisions, avert unnecessary revisions, and improve patient safety.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25679\">https:\/\/thejns.org\/doi\/10.3171\/CASE25679<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25679","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:47:26Z","timestamp":1771847246000},"source":"Crossref","is-referenced-by-count":0,"title":["Using phase-contrast MRI to assist in assessment of shunt function following postoperative intraventricular hemorrhage: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4797-5574","authenticated-orcid":true,"given":"Joseph H.","family":"Ha","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"},{"name":"Stanford University School of Medicine, Stanford"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew T.","family":"Borzage","sequence":"additional","affiliation":[{"name":"Fetal and Neonatal Institute, Division of Neonatology, Department of Pediatrics, Children\u2019s Hospital Los Angeles"},{"name":"University of Southern California Viterbi School of Engineering, Alfred E. Mann Department of Biomedical Engineering, Los Angeles"},{"name":"Department of Regulatory and Quality Sciences, University of Southern California Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Los Angeles"},{"name":"Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8652-6518","authenticated-orcid":true,"given":"Eamon K.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC, Los Angeles, California"},{"name":"Department of Radiology, Children\u2019s Hospital Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4963-7032","authenticated-orcid":true,"given":"Nicholas","family":"Sader","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Section of Pediatric Neurosurgery, Oklahoma Children\u2019s Hospital, Oklahoma City, Oklahoma"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madison","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Torres","sequence":"additional","affiliation":[{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6490-6032","authenticated-orcid":true,"given":"Jacob K.","family":"Al-Husseini","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"},{"name":"Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7732-632X","authenticated-orcid":true,"given":"Pradip P.","family":"Chaudhari","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC, Los Angeles, California"},{"name":"Division of Emergency and Transport Medicine, Children\u2019s Hospital Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clio","family":"Gonz\u00e1lez-Zacar\u00edas,","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Friedli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"},{"name":"University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0698-3055","authenticated-orcid":true,"given":"Jason M.","family":"Toliao","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"},{"name":"University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0996-3439","authenticated-orcid":true,"given":"John C.","family":"Wood","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason K.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark D.","family":"Krieger","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2035-9876","authenticated-orcid":true,"given":"Jason","family":"Hauptman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Gordon","family":"McComb","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"Keck School of Medicine of USC, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2124-797X","authenticated-orcid":true,"given":"Stefan","family":"Bl\u00fcml","sequence":"additional","affiliation":[{"name":"Department of Radiology, Children\u2019s Hospital Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Chiarelli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Children\u2019s Hospital Los Angeles"},{"name":"The Saban Research Institute, Children\u2019s Hospital Los Angeles"},{"name":"Keck School of Medicine of USC, Los Angeles, California"},{"name":"Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"J Neurosurg","first-page":"1117","article-title":"Quantitative noninvasive measurement of cerebrospinal fluid flow in shunted hydrocephalus","volume":"140","author":"Ha","year":"2023","unstructured":"Ha JHBorzage MTVanstrum EBQuantitative noninvasive measurement of cerebrospinal fluid flow in shunted hydrocephalus. 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J Neurosurg. 2023;140(4):1117-1128. doi:10.3171\/2023.7.JNS231326"},{"issue":"1","key":"bib2","series-title":"AJNR Am J Neuroradiol","first-page":"209","article-title":"Phase-contrast MR imaging support for the diagnosis of aqueductal stenosis","volume":"30","author":"Stoquart-El Sankari","year":"2009","unstructured":"Stoquart-El Sankari SSELehmann PGondry-Jouet CPhase-contrast MR imaging support for the diagnosis of aqueductal stenosis. AJNR Am J Neuroradiol. 2009;30(1):209-214. doi:10.3174\/ajnr.A1308"},{"issue":"8","key":"bib3","series-title":"J Appl Physiol (1985)","first-page":"976","article-title":"Predictors of cerebral blood flow in patients with and without anemia","volume":"120","author":"Borzage","year":"2016","unstructured":"Borzage MTBush AMChoi SPredictors of cerebral blood flow in patients with and without anemia. 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