I came across this article today as I was googling "failed ETVs." I was halfway through it when I realized that it was authored by the neurosurgical team with which my new neurosurgeon is partnered at the University of Utah.
This paragraph, in particular, is the protocol for failed ETVs, but I'm just so frustrated that if all the "regular" tests can produce false-negative results, WHY are we having to wait for surgery?! I feel like crapola!!
"Determining whether reclosure of the fenestration and recurrent hydrocephalus has developed can be clinically difficult, especially in the adult population presenting with chronic compensated hydrocephalus. In these patients, a return of symptoms may be fairly subtle and slow in onset. Because the ventricle size may change only minimally in these patients, this is not always a reliable indicator. If obstructive hydrocephalus has recurred, a diagnostic lumbar puncture may not reflect pressure within the ventricles and could also be potentially unsafe. Cine-flow magnetic resonance imaging may be helpful to demonstrate CSF flow through the ventricular fenestration; however, technical difficulties with such studies may yield false-negative results. If the return of clinical symptoms is compelling and diagnostic studies yield equivocal results regarding the status of the ventriculostomy, endoscopic reexploration is recommended."
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