How eye ultrasounds help detecting brain shunt failure in children: Research

The research suggests that employing ocular ultrasound can rapidly identify brain drainage tube malfunction in children.

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Enhanced Detection of Brain Drainage Tube Failure in Children with Ocular Ultrasound

Recent research, presented at the Pediatric Academic Societies (PAS) 2024 Meeting in Toronto, indicates that utilizing ocular ultrasound in the emergency room could promptly and safely identify children experiencing brain drainage tube failure. This tube, known as a ventricular shunt, is a vital device surgically inserted to drain excess fluid and alleviate pressure on the brain, particularly in cases of hydrocephalus—a condition stemming from inadequate brain fluid drainage or absorption due to factors such as tumors or brain bleeds. Experts note that approximately 30% of shunts experience malfunctions, misplacements, or blockages within two years post-implantation, with an additional 5% failing annually thereafter.

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Utilizing Ocular Ultrasound to Detect Shunt Failure Symptoms

Researchers note that when patients present at the emergency department with suspected shunt failure, they often exhibit nonspecific symptoms like headache, vomiting, and fatigue. Given the life-threatening nature of shunt failure, children with shunts typically undergo numerous computed tomography and magnetic resonance imaging scans each year, which exposes them to excessive radiation and necessitates sedation. Researchers highlight that a backup of fluid causes swelling in the optic nerve sheath, a phenomenon detectable through eye ultrasound. The study reveals that comparing the optic nerve diameter during symptomatic and asymptomatic periods can aid in identifying shunt blockages.

Adrienne L. Davis, MD, MSc, FRCPC, pediatric emergency medicine research director at The Hospital for Sick Children (SickKids) and presenting author, stated that the research team aims to reduce radiation exposure and expedite shunt failure diagnosis in the emergency department. The study employs a personalized approach by measuring the optic nerve in both healthy and symptomatic states, acknowledging that each patient with a shunt has unique dependence levels and brain pressure tolerances.