Ultrasonic evaluation of postventricular shunt dynamics in infants and young children.

Two-dimensional echoencephalography provides a noninvasive method of monitoring the response of hydrocephalus to shunting in young children and of detecting complications of shunting. In this study an average of 74% of the decrease of ventricular size seen within the first six postoperative days had occurred by the first postoperative day. An average of 49% of the eventual decrease in ventriculography size occurred within the first postoperative week. The most helpful scans in the early postoperative period were obtained on the first postoperative day and again in the latter half of the first week. A clear departure from the usual pattern may indicate children at particular risk for significant shunt-related problems. While shunt failure was the most common complication, others such as mantle collapse with subdural hygromas, subgaleal fluid collections, loculations secondary to fibrous adhesions, and arachnoid cysts can be clearly defined.