Cerebrospinal shunt malfunction: recognition and emergency management.

Indwelling shunts to divert CSF flow are essential in treating hydrocephalus. There is a high incidence of shunt malfunction, which accounts for the increasing popularity of endoscopic third ventriculostomy. Failure to recognize and act on symptoms and signs of shunt malfunction may lead to loss of life or to permanent neurological dysfunction. This review provides the basis for assessment and management based on updated clinical knowledge.