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The diagnosis of cerebrospinal fluid (CSF) shunt failure is difficult even for experienced clinicians because the cardinal symptoms—headache, vomiting, lethargy—are so prevalent in common childhood illnesses such as otitis, gastroenteritis, and various viral syndromes. Pediatricians, parents, and other caretakers must be informed and vigilant, because for each episode of shunt failure the mortality rate is greater than 1%.1 Deaths from shunt failure commonly occur out of hospital despite symptomatic prodromes lasting days to …
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