Clinical Examination (Shunt Dysfunction)

Figure hydr_29a_n.jpg and hydr_29b_n.jpg: Clinical examination of the shunt. The inspection and palpation of the shunt may in case of suspected shunt insufficiency yield some additional information: Visible CSF cushion or absent continuity of parts of the shunt = disconnection; or findings as shown in the following case: The initially full chamber hydr_29a_n.jpg !£hydr_29a_p£! becomes visibly and palpably depressed following compression of the chamber hydr_29b_n.jpg !£hydr_29b_p£!. The visible dent points to an absent or reduced flow of CSF from the ventricle due to an obstructed ventricular catheter. This finding can only be interpreted under emergency condition as sign of partial or total occlusion of the central catheter in combination with clinical signs.