Intrathecal radioisotopes and phlebography in investigation of ventriculo-atrial shunts in children

The Authors describe their experience in investigating the functioning and patency of ventriculo-venous shunts in hydrocephalic patients. They examined 41 hydrocephalic children with Pudenz valves, with radioisotope techniques. The radioactive tracers were administered by the lumbar route, by the ventricular route, or directly into the shunt. For lumbar or ventricular administration 131I-HSA, 99mTc-HSA and 169Yb-DPTA were used, whilst 99mTCO4 was the only isotope used for direct introduction into the shunt, effected by piercing the pump of the Pudenz system. The results of these investigations show that introduction of the isotope into the shunt allows obtaining morphological information, depending on the patency of the shunt and on the site of any obstruction. It also provides information about the functioning of the shunt, depending on the presence of hyper- or hypo-shunting. In cases where revision of the distal catheter might be necessary, moreover, phlebographic investigations of the superior vena cava were made. These proved to be particularly useful for indicating the patency of the affluent veins of the heart, thus enabling a precise surgical schedule to be planned prior to operation.

Anomalous duplication of the posterior part of the internal cerebral vein and the great vein of Galen. Case report

✓ The authors present a case of anomalous duplication of the posterior part of the internal cerebral vein and probably of the great vein of Galen, and hypothesize a relationship with subarachnoid hemorrhage.