Abstract
Objective: The purpose of this study was to review the clinical features of a group of patients in whom ventricular enlargement was not a manifestation of prolonged CSF shunt obstruction. Results: Twelve patients who had prolonged symptoms consistent with CSF shunt failure and stable normal ventricular size were demonstrated at the time of surgery to have obstruction of their CSF shunts. Conclusion: Ventricular enlargement is a common but not sine qua non indicator of CSF shunt failure, even after weeks or months of elevated intracranial pressure, and therefore cannot be relied upon for the diagnosis of CSF shunt failure. Although an increase in ventricular size is usually seen relatively early in the course of shunt malfunction, stable normal ventricular size in patients with symptoms and signs that are consistent with shunt failure can delay the diagnosis with potentially serious adverse consequences.
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