It is generally possible to evaluate a malfunctioning shunt on the basis of clinical signs. Neuroradiologic evaluation is recommended for the difficult cases when this is not possible. The neuroradiologic procedure of choice is cerebral angiography since it permits the determination of ventricular size, an estimate of the presence of intraventricular hypertension, and an evaluation of the nature and degree of brain shift or herniation. Furthermore, such complications of hydrocephalus as porencephaly or subdural accumulations of fluid may also be diagnosed.
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