BMJ Case Reports 2018; doi:10.1136/bcr-2017-223861
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Use of CSF infusion studies to unblock occluded hydrocephalus ventricular shunt catheters: a preliminary report of two patients

  1. Zofia Helena Czosnyka2
  1. 1Clinical Neurosciences, Division of Neurosurgery, Cambridge University Hospital, Cambridge, UK
  2. 2University of Cambridge, Clinical Neurosciences, Cambridge, Cambridgeshire, UK
  1. Correspondence to Dr Afroditi Despina Lalou, adl43{at}
  • Accepted 19 April 2018
  • Published 16 May 2018


Two patients with ventriculoperitoneal shunts presented with symptoms of raised intracranial pressure indicative of possible shunt malfunction. During investigation, to eliminate this possibility, cerebral spinal fluid infusion studies were performed, which indicated proximal occlusion of the shunts in both cases. Retrograde flush of the ventricular catheter was performed during temporary compression of the siphon-control device, a manoeuvre which blocks distal flow. After the use of this technique, both patients' symptoms improved and they have remained symptom-free for over 2 years. This case report validates the role that infusion studies can play in clearing a blocked ventricular catheter shunt.


  • Contributors EN contributed to planning the report, wrote the manuscipt and collected the imaging and patients' data and information. ADL contributed to planning, assisted in writing and editing the manuscipt and collected the patients' infusion data. JDP supervised the planning and organisation of the report, edited the manuscript and provided his expert feedback and editing in the end result. ZHC provided the idea for the report and gave her senior supervision and expertise to the interpretation of the patients' CSF infusion test results in the final report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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