On imaging shunt was found to be in suboptimal position and there was fluid tracking around catheter.During shunt revision, csf flow was under moderately high pressure.The manometer was then brought into the field and connected to the proximal portion of the valve.However, there was no distal runoff through the valve.In fact, we could not forcefully irrigate through the valve either.The valve was then removed and we investigated distal runoff directly to the peritoneal catheter, which was found to be flowing appropriately without resistance.Decision was therefore made to exchange the valve.
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