Non-invasive diagnostic device to detect shunt malfunction

ShuntCheck is a non-invasive device made by NeuroDx Development. It can be used in the care of people with hydrocephalus to assess shunt function and help to diagnose malfunction and blockage. ShuntCheck monitors the function of shunt systems by detecting the flow of cerebrospinal fluid (CSF) through the shunt using a sensor placed on the skin of the clavicle. The ShuntCheck sensor is an advanced thermometer that detects CSF flow through a technology called thermal dilution.

An ice pack is placed upstream of the sensor to cool the CSF in the shunt. If the shunt is working, the cooled CSF will flow freely downwards and the ShuntCheck will detect a drop in temperature. The faster the CSF flows through, the bigger the drop in temperature recorded. If the shunt is blocked or malfunctioning the cooled fluid doesn’t flow through so the sensor does not detect a temperature drop.

To tell the difference between a temporarily non-flowing shunt and an obstructed shunt the ShuntCheck diagnostic kit includes a handheld device called a Micro-Pumper which vibrates the shunt valve. The Micro-pumper temporarily increases CSF flow through working shunts but not through obstructed ones.

There are a number of possible ways ShuntCheck can be used in the medical care of people with hydrocephalus:

1.     Assessing shunt function in patients with symptoms of shunt malfunction. 

2.     Routinely establishing baseline CSF flow in people with hydrocephalus. Knowing what ‘normal’ CSF flow looks like in someone with hydrocephalus can make it easier to spot a problem if they then develop symptoms.

3.     Valve adjustment. Shuntcheck can measure changes in CSF flow due to changes in the valve setting, so can be used to help find the right setting for an individual.

4.     Assessing suspected over-drainage. ShuntCheck could be used to identify periods and causes of increased CSF flow when investigating suspected over drainage.

5.     Confirmation of shunt function after surgery. Shunt function is sometimes assessed by postoperative scan before a patient can be allowed home. ShuntCheck can confirm shunt function quicker than CT scan as there is no need to wait for the ventricles to stabilize.

The ShuntCheck System is now on its third version after going through clinical trials which have led to improvements in the device’s performance.

One large multi-centre study published in Neurosurgery used ShuntCheck as a diagnostic test for suspected shunt blockage in children with symptomatic hydrocephalus. The researchers concluded that ShuntCheck can be used alongside clinical judgment to rule out shunt malfunction which can reduce the need for imaging (especially involving radiation) admissions for observation and invasive tests.

ShuntCheck does not yet have MHRA approval for use in the UK but as the evidence for its clinical usefulness builds it will hopefully be integrated into clinical practice in the NHS.

If you have any questions, please get in touch with us at firstcontact@shinecharity.org.uk  and they can connect you with the health team.