Assessment of ventricular fluid shunting by computer tomography

Cerebral computer tomography (CT) gives precise information about the size of the ventricular system and has therefore become a valuable tool in the handling of hydrocephalic patients. The indications for the diversion of cerebrospinal fluid to the peritoneal cavity or the right atrium is in part based on CT scan results. Reduced ventricular size is regarded as a sign of effective shunting. In case of acute shunt failure however, ventricular enlargement may take some time. The situation may furthermore be misinterpreted because the last CT scan was taken a long time ago, or was taken during a previous episode of shunt failure. A CT scan should never be used alone to exclude the diagnosis of shunt failure, especially if the clinical signs support this diagnosis. We have during the last years seen five children die from acute shunt failure where the correct diagnosis was postponed partly because of misinterpreted CT scans