Acta Neurochirurgica

, Volume 159, Issue 6, pp 981–986

I can hear my shunt—audible noises associated with CSF shunts in hydrocephalic patients

  • Stefanie Kaestner
  • Amina Fraij
  • Wolfgang Deinsberger
  • Christian Roth
Original Article - Abstract

Abstract

Background

Cerebrospinal fluid (CSF) shunts are life-long implants, and patients have reported anecdotally on noises associated with their shunts. There is, however, a marked lack of information regarding acoustic phenomena related to CSF shunts.

Methods

We identified all patients who had been treated or followed in our neurosurgical department within a 15-year period from January 2000 up to the end of 2014. After approval of the local ethics committee all patients who were cognitively intact were explored by a questionnaire and by personal interview about acoustic phenomena related to their shunts.

Results

Three hundred forty-seven patients were eligible for the survey, and 260 patients completed the questionnaire. Twenty-nine patients (11.2%) reported on noises raised by their shunts. All of them experienced short-lasting noises while changing body posture, mainly from a horizontal to an upright position, or while reclining the head. Most of the patients reported on soft sounds, but loud and even very loud noises occurred in some patients. Seventy-six percent of the patients were not bothered by these noises as they considered it as a normal part of the therapy or as proof that the shunt device was functioning. Modern valves with gravitational units are prone to produce noises in young adults, but nearly all valve types can evoke noises.

Conclusions

Noises caused by a shunt do occur in a considerable number of patients with shunts. One should be aware of this phenomenon, and these patients must be taken seriously.

Keywords

CSF shunt Noise Shunt valve 

References

  1. 1.
    Flannery AMP, Mitchell L (2014) Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 1-10. J Neurosurg Pediatr 14(Suppl 1):3–81CrossRefPubMedGoogle Scholar
  2. 2.
    Jensen F, Jensen FT (1979) Acquired hydrocephalus. I. A clinical analysis of 160 patients studied for hydrocephalus. Acta Neurochir 46(1–2):119–133CrossRefPubMedGoogle Scholar
  3. 3.
    Koertke H, Hoffmann-Koch A, Boethig D, Minami K, Breymann T, El-Arousy M (2003) Does the noise of mechanical heart valve prostheses affect quality of life as measured by the SF-36 questionnaire? Eur J Cardiothorac Surg 24(1):52–57CrossRefPubMedGoogle Scholar
  4. 4.
    Kolenda H, Schoener W (1995) Shunt-valve noise as an unusual reason for shunt revision. Childs Nerv Syst 11:489–491CrossRefPubMedGoogle Scholar
  5. 5.
    Martines F, Sireci F, Cannizzaro E, Constanzo R, Martines E, Mucia M, Plescia F, Salvago P (2015) Clinical observations und risk factors for tinnitus in a Sicilian cohort. Eur Arch Otorhinolaryngol 272(10):2719–2729CrossRefPubMedGoogle Scholar
  6. 6.
    Moritz A, Steinseifer U, Kobinia G, Neuwirth-Riedl K, Wolters H, Reul H (1992) Closing sounds and related complaints after heart valve replacement with St Jude Medical, Duromedics Edwards, Björk-Shiley Monostrut, and Carbomedics prostheses. Br Heart J 67(6):460–465CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Nakano A, Tani E, Sato M, Shimizu Y (1994) Cerebrospinal fluid leakage from the nipple after ventriculoperitoneal shunt: case report. Surg Neurol 42(3):224–226CrossRefPubMedGoogle Scholar
  8. 8.
    Ordia JI, Mortara RW, Spatz EL (1987) Audible cerebrospinal fluid flow through a ventriculoperitoneal shunt. Report of two cases. J Neurosurg 67(3):460–462CrossRefPubMedGoogle Scholar
  9. 9.
    Stockhammer F, Miethke C, Knitter T, Rohde V, Sprung C (2014) Flow-related noise in patients with ventriculoperitoneal shunt using gravitational adjustable valves. Acta Neurochir 156:761–765CrossRefPubMedGoogle Scholar
  10. 10.
    Tan LA, Kasliwal MK, Moftakhar R, Munoz LF (2014) Ventriculoperitoneal shunt with a rare twist: small-bowel ischemia and necrosis secondary to knotting of peritoneal catheter. J Neurosurg Pediatr 14(3):234–237CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  1. 1.Department of NeurosurgeryKlinikum KasselKasselGermany
  2. 2.Kassel School of MedicineUniversitiy of SouthamptonSouthamptonUK
  3. 3.Empiric Educational Science FB 01University of KasselKasselGermany
  4. 4.Department of NeurologyKlinikum KasselKasselGermany

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