{"id":"29a3d5c6-18e2-410e-992f-43cf5c1c91b1","slug":"noninvasive-thermal-evaluation-for-shunt-failure-in-the-emergency-room","title":"Noninvasive thermal evaluation for shunt failure in the emergency room","authors":["Jordan Xu","Cassie Poole","Ronald Sahyouni","Jefferson Chen"],"abstract":"Background: Ventriculoperitoneal shunts (VPSs) have been the mainstay of treating hydrocephalus since the 1950s. However, shunts have a reported complication rate reaching nearly 50%. Devices have been developed that utilize noninvasive thermal transcutaneous diffusion technology. These shunt evaluation devices measure temperature gradients to detect shunt cerebrospinal fluid flow. We assessed the utility using a thermal diffusion technique to work up shunt failure in the emergency room (ER). Methods: This was a retrospective case series at a single medical center ER. We included consecutive patients with possible VPS malfunction who were evaluated with a thermal sensor. The time period of data collection included September 2015–April 2018. Results: Eight patients were reviewed, including four males and four females. The average age of reviewed patients was 35.1 (+/− ; 16.5). In our case series, three patients had adequate shunt flow as assessed by the shunt evaluation device, and the decision was made to discharge the patient and follow-up in clinic. In two patients, the flow was diminished, but due to other reassuring signs, the patients were still discharged with follow-up. Two patients were noted to have poor flow and were admitted for shunt revision. Conclusion: It is important to determine whether a malfunction is present and whether an intervention is necessary for patients who present to the emergency department with possible symptoms of shunt failure. A thermal sensor is a fast and noninvasive tool in the evaluation of shunt flow and helps determine whether it is safe to send a patient home or intervene appropriately.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/29a3d5c6-18e2-410e-992f-43cf5c1c91b1/featured/hero-1781563652291.png","publishDate":"2019-12-27T00:00:00.000Z","doi":"10.25259/SNI_324_2019","categories":["General Neurosurgery","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2019/12/9824/SNI-10-254.pdf"}