Hi guys,
Graduating ED resident here. Had a question about VP shunt taps and their interpretation. I recently had a patient with some transient 3rd ventricular enlargement but subsequent persistent symptoms of Paranauds. An MRI was obtained and did not show evidence of parenchymal disease. A VP shunt had recently been placed and a tap was performed. Opening pressure was zero mmhg however flow was observed. The shunt was initially not felt to be the cause of her dorsal midbrain syndrome, but later on was felt to be at blame as no other cause was identified. She underwent EVD then revision and her symptoms resolved. So my question to you is, can you help me interpret what a tap with flow of 0 mm means? I understand that decreased flow likely lends itself to a proximal limb or possibly a reservoir problem, but what does it mean in the setting of flow? is this normal, reassuring? Why isn't the OP higher?
Thanks y'all
migm
Graduating ED resident here. Had a question about VP shunt taps and their interpretation. I recently had a patient with some transient 3rd ventricular enlargement but subsequent persistent symptoms of Paranauds. An MRI was obtained and did not show evidence of parenchymal disease. A VP shunt had recently been placed and a tap was performed. Opening pressure was zero mmhg however flow was observed. The shunt was initially not felt to be the cause of her dorsal midbrain syndrome, but later on was felt to be at blame as no other cause was identified. She underwent EVD then revision and her symptoms resolved. So my question to you is, can you help me interpret what a tap with flow of 0 mm means? I understand that decreased flow likely lends itself to a proximal limb or possibly a reservoir problem, but what does it mean in the setting of flow? is this normal, reassuring? Why isn't the OP higher?
Thanks y'all
migm