Shunt Dysfunction (Differential Diagnosis as before)

Figure comm_19a_n.jpg and comm_19b_n.jpg: In case of headache, vomiting, and a possible clouding of consciousness, the possibility of a shunt dysfunction has to be considered; mainly if a history of trauma is doubtful and/or if the patient has a shunt. Figure comm_19a_n.jpg: 6.3-year-old boy with acute shunt failure. Notice the sunset phenomenon (Parinaud sign). Figure comm_19b_n.jpg: Fluctuating unconsciousness of different degree: GCS 6 with absent eye opening, incomprehensible verbal communication and flexion. From time to time, GCS is less than 6, with decerebrate postural pattern, such as opisthotonus; $$comm_1??££see alternate figures§§.