Abstract
Purpose
Ventriculoperitoneal (VP) shunt is one of the most commonly performed procedures by a neurosurgeon. It is occasionally fraught with the most bizarre complications. Understanding the pathophysiology of these complications can help us make the procedure safe and more effective.
Methods
The authors report a case of 8-year-old boy, previously operated for lumbar myelomeningocele and hydrocephalus with an intra diploic migration of shunt tube and shunt dysfunction, and discuss the pathophysiology, diagnosis, and surgical strategy.
Results
After diagnosis of shunt malfunction, shunt revision was done with placement of new system and removal of the old apparatus. Patient had a remarkable recovery after the surgery.
Conclusion
Intradiploic migration is an extremely rare cause of shunt malfunction and has never been reported in literature before. Possible mechanism is that prolonged pressure on the valve due to recumbent head position in a paraplegic child might have led to new bone formation and subsequent intradiploic migration of the valve. Careful planning the position of shunt valve in relation to head position, especially in children who are recumbent due to paraplegia might avoid this untoward complication.
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References
Goeser CD, McLeary MS, Young LW (1998) Diagnostic imaging of ventriculoperitoneal shunt malfunctions and complications. Radiographics 18(3):635–651. doi: 10.1148/radiographics.18.3.9599388
Sato TS, Moritani T, Hitchon P (2009) Occipital Intradiploic CSF Pseudocyst: an Unusual Complication of a Ventriculoperitoneal Shunt Malfunction. AJNR Am J Neuroradiol 30:635–636. doi:10.3174/ajnr.A1320
Martin E Weinand, Setti S Rengachary, Douglas H McGregor, Itaru Watanabe (1989) Intradiploic arachnoid cysts. J Neurosurg 70:954–958. doi: 10.3171/jns.1989.70.6.0954
AZAR-KIA B, PALACIOS E, Cooper RA (1975) Unusual features of leptomeningeal cysts. Am J Roentgenol Radium Ther Nucl Med 124:387–391
Hillman RSL, Kieffer SA, Ortiz H, Clubb R (1975) Intraosseous Leptomeningeal Cysts of the Posterior Cranial Fossa1. Radiology 116:655–659. doi: 10.1148/116.3.655
Shapiro R, Robinson F (1976) Embryogenesis of the human occipital bone. Am J Roentgenol 126:1063–1068. doi:10.2214/ajr.126.5.1063
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Joshi, K.C., Khanapure, K., Jagannatha, A.T. et al. The vanishing shunt valve. Childs Nerv Syst 31, 2207–2209 (2015). https://doi.org/10.1007/s00381-015-2791-6
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DOI: https://doi.org/10.1007/s00381-015-2791-6