Shunt Malfunction

Shunt malfunction is typically the result of an obstruction in the shunt system. This may be proximal (in or around the ventricular catheter) or distal (in or around the peritoneal or other distal end). Occasionally, the valve may be obstructed by debris. These situations will often require surgery for replacement of the obstructed portion.

Proximal obstruction of the ventricular catheter is typically caused by adherent choroid plexus, debris, blood, or adherent brain tissue. Rarely, growing tumor or the inflammation resulting from infection can also result in proximal obstruction.

In the peritoneal cavity, obstruction is typically the result of low-grade infection that eventually causes formation of a pseudocyst around the tip of the catheter. Obstruction may also be caused by debris or malposition of the catheter from the initial surgery. Progressive growth of a patient who had a catheter placed early in childhood can lead to its withdrawal from the peritoneal cavity because it becomes too short for the patient's gradual increase in length. This previously common occurrence is relatively rare today because long redundant lengths of tubing are left in the abdomen at initial placement to account for expected growth. Disconnections, breaks, kinks, and other mechanical disruptions in the distal tubing may also occur.

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