Ventriculoperitoneal shunt mechanical failure - Revision history

ClaireLewis: /* Evaluation */

2019-10-03T16:54:32Z

Evaluation

← Revisión anterior		Revisión del 16:54 3 oct 2019
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	==Evaluation==		==Evaluation==
	*Shunt series (AP and lateral x=rays of skull, AP x-rays of chest and abdomen)		*Shunt series (AP and lateral x=rays of skull, AP x-rays of [[CXR\|chest]] and [[KUB\|abdomen]])
	*Consider [[CT head]]		*Consider [[CT head]]
	*24% of patients with documented shunt malfunction may show no radiologic evidence of the malfunction on plain films or CT<ref>Kim TY, Stewart G: Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department. Pediatr Emerg Care. 2006; 22: 1.</ref>		*24% of patients with documented shunt malfunction may show no radiologic evidence of the malfunction on plain films or CT<ref>Kim TY, Stewart G: Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department. Pediatr Emerg Care. 2006; 22: 1.</ref>

2019-10-01T23:52:30Z

← Revisión anterior		Revisión del 23:52 1 oct 2019
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	==Clinical Features==		==Clinical Features==
	*Shunt fractures may present with localized symptoms over the area (pain, erythema, fluid at skin)		*Shunt fractures may present with localized symptoms over the area (pain, erythema, fluid at skin)
	*Features of ~~raised~~ ICP		*Features of [[elevated ICP]]
	**Bulging ~~fontanelles~~ in infants		**[[Bulging fontanelle]]s in infants
	**Irritability, lethargy		**Irritability, [[lethargy]]
	**Headache		**[[Headache]]
	**Nausea ~~and~~ vomiting, poor feeding		**[[Nausea/vomiting]], poor feeding
	**Seizure		**[[Seizure]]
	**Cushing's triad		**Cushing's triad

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	*Neurosurgery consult		*Neurosurgery consult
	**If critically high ICP and no neurosurgeon available, may need to tap shunt as temporizing measure		**If critically high ICP and no neurosurgeon available, may need to tap shunt as temporizing measure

	==Disposition==		==Disposition==

2016-09-24T11:39:37Z

Evaluation

← Revisión anterior		Revisión del 11:39 24 sep 2016
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	==Evaluation==		==Evaluation==
	*Shunt series (AP and lateral x=rays of skull, AP x-rays of chest and abdomen)		*Shunt series (AP and lateral x=rays of skull, AP x-rays of chest and abdomen)
	*Consider CT ~~Head~~		*Consider [[CT head]]
	*24% of patients with documented shunt malfunction may show no radiologic evidence of the malfunction on plain films or CT<ref>Kim TY, Stewart G: Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department. Pediatr Emerg Care. 2006; 22: 1.</ref>		*24% of patients with documented shunt malfunction may show no radiologic evidence of the malfunction on plain films or CT<ref>Kim TY, Stewart G: Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department. Pediatr Emerg Care. 2006; 22: 1.</ref>

	==Management==		==Management==
	*Neurosurgery consult		*Neurosurgery consult

2016-09-24T11:38:38Z

2016-09-08T16:10:32Z

← Revisión anterior		Revisión del 16:10 8 sep 2016
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	**Occurs shortly after insertion		**Occurs shortly after insertion
	*Migration		*Migration
			**Presents as shunt failure
	*Misplacement		*Misplacement
	**Usually manifests postoperatively		**Usually manifests postoperatively

	==Clinical Features==		==Clinical Features==
			*Shunt fractures may present with localized symptoms over the area (pain, erythema, fluid at skin)
			*Features of raised ICP
			**Bulging fontanelles in infants
			**Irritability, lethargy
			**Headache
			**Nausea and vomiting, poor feeding
			**Seizure
			**Cushing's triad

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
			*Shunt series (AP and lateral x=rays of skull, AP x-rays of chest and abdomen)
			*Consider CT Head
			*24% of patients with documented shunt malfunction may show no radiologic evidence of the malfunction on plain films or CT<ref>Kim TY, Stewart G: Signs and symptoms of cerebrospinal fluid shunt malfunction in the pediatric emergency department. Pediatr Emerg Care. 2006; 22: 1.</ref>
	==Management==		==Management==
			*Neurosurgery consult
			**If critically high ICP and no neurosurgeon available, may need to tap shunt as temporizing measure
	==Disposition==		==Disposition==

	==See Also==		==See Also==
			*[[Ventriculoperitoneal shunt obstruction]]
			*[[Ventriculoperitoneal shunt overdrainage]]
			*[[Ventriculoperitoneal shunt infection]]
	==External Links==		==External Links==

2016-07-26T19:25:16Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-14T14:29:59Z

Text replacement - "incr " to "increased "

← Revisión anterior		Revisión del 14:29 14 jul 2016
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	*Fracture of tubing		*Fracture of tubing
	**Occurs many years after shunt placement in distal tubing		**Occurs many years after shunt placement in distal tubing
	**May present with mild symptoms of ~~incr~~ ICP and local symptoms of pain, erythema, edema		**May present with mild symptoms of increased ICP and local symptoms of pain, erythema, edema
	*Disconnection		*Disconnection
	**Occurs shortly after insertion		**Occurs shortly after insertion

2016-07-13T11:12:51Z

Text replacement - " w/ " to " with "

← Revisión anterior		Revisión del 11:12 13 jul 2016
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	*Fracture of tubing		*Fracture of tubing
	**Occurs many years after shunt placement in distal tubing		**Occurs many years after shunt placement in distal tubing
	**May present w/ mild symptoms of incr ICP and local symptoms of pain, erythema, edema		**May present with mild symptoms of incr ICP and local symptoms of pain, erythema, edema
	*Disconnection		*Disconnection
	**Occurs shortly after insertion		**Occurs shortly after insertion

2016-03-22T14:14:27Z

Text replacement - "Category:Neuro" to "Category:Neurology"

2015-07-20T11:15:18Z

← Revisión anterior		Revisión del 11:38 24 sep 2016
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	==See Also==		==See Also==
	*[[Ventriculoperitoneal shunt ~~obstruction~~]]		*[[Ventriculoperitoneal shunt problems]]
	*[[Ventriculoperitoneal shunt overdrainage]]
	*[[Ventriculoperitoneal shunt infection]]
	==External Links==		==External Links==