A physician reported on (b)(6), 2020 a stator dislodgement issue with a shunt valve.A hakim programmable shunt was implanted in a patient when the patient was 3 months old in 2008 (exact date not available).The shunt was most recently reprogrammed in 2013, at that time an x-ray demonstrated the set pressure settings along with the radio-opaque marker for identification/reading.On (b)(6), 2020, the patient presented for follow-up evaluation with complaints of early morning headaches and the parents reporting the patient ¿sunset sign in the mornings ¿and clinically had a partial up gaze paresis.The neurosurgeon had not evaluated this patient for the last 7 years in follow-up and could not comment if this paresis was a permanent residual deficit.An x-ray was ordered to identify the current pressure settings and to inform any further actions.Reportedly the x-ray of the valve appeared ¿differently from how a typical codman hakim programmable valve x-ray appears.¿ there was no radio-opaque dot on the right-hand side and the pressure setting notch was not as expected.No further information was available.
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