Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
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In 14 children with indwelling ventriculoatrial or ventriculoperitoneal shunts, the need for continued shunt treatment was judged to be uncertain based on clinical symptoms and signs and CT scans. Ventricular outflow resistance (R0) was determined by implantation of a ventricular catheter and steady state infusion of artificial cerebrospinal fluid (CSF) according to the formula R0 = (Pp - P0)/Infusion rate, where P0 is the opening pressure in the lateral ventricle and Pp the plateau pressure recorded at that particular infusion rate. R0 was determined during general anesthesia and steady state ventilation was ensured by mechanical ventilator. ⋯ Seven children demonstrated increased R0 values even after shunt unclamping. Their shunts were replaced, and clinical improvement has been observed in 6 of them. Ventricular infusion tests appear useful to evaluate shunt dependence and function in difficult cases.