Ventriculoperitoneal shunt overdrainage: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Vague symptoms of dizziness, visual | *Vague symptoms of [[dizziness]], [[visual disturbances]] | ||
*Worsened with standing/exertion | *Worsened with standing/exertion | ||
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==Evaluation== | ==Evaluation== | ||
*CT | *[[CT head]] necessary for shunt placement workup and over-drained ventricles | ||
*Patients at higher risk for subdural hematomas | *Patients at higher risk for [[subdural hematomas]] | ||
[[File:Slitvent.png|thumb]] | [[File:Slitvent.png|thumb]] | ||
Revision as of 16:55, 3 October 2019
Background
- Overdrainage → tissue occluding the orifices of the proximal shunt apparatus
- As pressure increases the occluding tissue diesengages allowing drainage to resume
- Leads to cyclic increased ICP complaints that worsen when patient stands
- Newer valve devices with antisiphon features make this less common
Clinical Features
- Vague symptoms of dizziness, visual disturbances
- Worsened with standing/exertion
Differential Diagnosis
Ventriculoperitoneal shunt problems
- Ventriculoperitoneal shunt obstruction
- Ventriculoperitoneal shunt overdrainage (Slit Ventricle Syndrome)
- Ventriculoperitoneal shunt infection
- Ventriculoperitoneal shunt mechanical failure
Evaluation
- CT head necessary for shunt placement workup and over-drained ventricles
- Patients at higher risk for subdural hematomas
Management
- Neurosurgery consult
Disposition
- Admission for shunt revision versus valve adjustment