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Valvulography: A Test for Patency of Holter Valve Shunts

Valvulography: A Test for Patency of Holter Valve Shunts Abstract ONE OF the most common problems in the management of patients with hydrocephalus and persistent subdural effusions is the evaluation of the shunt system to determine its patency. The classical method of determining whether or not a shunt system is patent is to utilize the simple digital or manual pumping technique which at times may not be reliable. A partially malfunctioning valve is almost impossible to evaluate clinically. Another problem which frequently plagues the surgeon is the identification of which end of the obstructive system is at fault. Simple radiographic evaluation of the broken tube occurs too infrequently to be of consistent value. Radioactive material, such as iodinated I131 serum albumin (Risa 131), has been utilized1-6 to study cerebrospinal flow through shunt systems. Usually this material is injected into the lateral ventricle and its concentration in the blood stream or in the distal limb of the tubing is determined. References 1. Atkinson, J.R., and Foltz, E.L.: Intraventricular "RISA" as a Diagnostic Aid in Pre and Post Operative Hydrocephalus , J Neurosurg 19:159-166, 1962.Crossref 2. Bell, R.L.: Isotope Transfer Test in the Diagnosis and Treatment of Hydrocephalus , Int J Appl Radiat 5:89-93 ( (March) ) 1959.Crossref 3. Bering, E.A., and Osamu, S.: Hydrocephalus: Changes in Formation and Absorption of Cerebrospinal Fluid Within the Cerebral Ventricles , J Neurosurg 20:1050-1063 ( (Dec) ) 1963.Crossref 4. Kagen, A., et al: Test for Patency of Ventriculo-Vascular Shunt for Hydrocephalus With Radioactive Iodinated Serum Albumin , J Neurosurg 20: 1025-1028 ( (Dec) ) 1963.Crossref 5. Migliore, A.; Paoletti, P.; and Villani, R.: Radioisotope Method for Evaluating the Patency of the Spitz-Holter Valve , J Neurosurg 19:605 ( (July) ) 1962.Crossref 6. Schlesinger, E.B.; DeBoves, S.; and Cheek, W.: A Method for the Evaluation of the Patency of Shunts in the Treatment of Obstructive Hydrocephalus , Trans Amer Neurol Assoc 84:197 ( (June) ) 1959. 7. Pudenz, R.H., et al: Ventriculo-Auriculostomy: A Technique for Shunting Cerebrospinal Fluid Into the Right Auricle: Preliminary Report , J Neurosurg 14:171-179 ( (March) ) 1957.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Valvulography: A Test for Patency of Holter Valve Shunts

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Publisher
American Medical Association
Copyright
Copyright © 1969 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1969.02100030192012
Publisher site
See Article on Publisher Site

Abstract

Abstract ONE OF the most common problems in the management of patients with hydrocephalus and persistent subdural effusions is the evaluation of the shunt system to determine its patency. The classical method of determining whether or not a shunt system is patent is to utilize the simple digital or manual pumping technique which at times may not be reliable. A partially malfunctioning valve is almost impossible to evaluate clinically. Another problem which frequently plagues the surgeon is the identification of which end of the obstructive system is at fault. Simple radiographic evaluation of the broken tube occurs too infrequently to be of consistent value. Radioactive material, such as iodinated I131 serum albumin (Risa 131), has been utilized1-6 to study cerebrospinal flow through shunt systems. Usually this material is injected into the lateral ventricle and its concentration in the blood stream or in the distal limb of the tubing is determined. References 1. Atkinson, J.R., and Foltz, E.L.: Intraventricular "RISA" as a Diagnostic Aid in Pre and Post Operative Hydrocephalus , J Neurosurg 19:159-166, 1962.Crossref 2. Bell, R.L.: Isotope Transfer Test in the Diagnosis and Treatment of Hydrocephalus , Int J Appl Radiat 5:89-93 ( (March) ) 1959.Crossref 3. Bering, E.A., and Osamu, S.: Hydrocephalus: Changes in Formation and Absorption of Cerebrospinal Fluid Within the Cerebral Ventricles , J Neurosurg 20:1050-1063 ( (Dec) ) 1963.Crossref 4. Kagen, A., et al: Test for Patency of Ventriculo-Vascular Shunt for Hydrocephalus With Radioactive Iodinated Serum Albumin , J Neurosurg 20: 1025-1028 ( (Dec) ) 1963.Crossref 5. Migliore, A.; Paoletti, P.; and Villani, R.: Radioisotope Method for Evaluating the Patency of the Spitz-Holter Valve , J Neurosurg 19:605 ( (July) ) 1962.Crossref 6. Schlesinger, E.B.; DeBoves, S.; and Cheek, W.: A Method for the Evaluation of the Patency of Shunts in the Treatment of Obstructive Hydrocephalus , Trans Amer Neurol Assoc 84:197 ( (June) ) 1959. 7. Pudenz, R.H., et al: Ventriculo-Auriculostomy: A Technique for Shunting Cerebrospinal Fluid Into the Right Auricle: Preliminary Report , J Neurosurg 14:171-179 ( (March) ) 1957.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1969

References