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Twenty-four percent of the reports made no mention of shunt malfunction.In this group,the ventricular system was described as"unchanged","stable,"" normal","unremarkable","small","smaller","slit","negative",and"no hydrocephalus"with no other comment to support a diagnosis of shunt malfunction.An additional 9%of reports contained the same terms,while also hinting at some other clinical or radiographic data that suggest the possibility of shunt failure(EG,a shunt disconnection seen on plain radiographs)despite the scan findings.In all patients in this group, symptoms improved after surgery.We conclude that as many as one-third of patients presenting with shunt malfunction will not have the diagnosis of shunt malfunction supported by a prospective radiologic interpretation of brain imaging.Although the neurosurgical community can assess the clinical situation to determine the need for further,other clinicians can be easily reassured by a radiographic report that does not mention or diagnose shunt malfunction.Today,more than ever,nonneurosurgeons are being called on to evaluate complex clinical situations and may rely on radiographic reports. |
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