title: An unusual complication of tapping a ventriculoperitoneal shunt.
abstract: A case is reported describing a complication of an unsuccessful attempt to aspirate the reservoir of a ventriculoperitoneal shunt system with a suspected shunt infection. This arose due to a misunderstanding of the anatomy of the shunt and resulted in an intracerebral haematoma. The complications of cerebrospinal fluid shunting and the difficulty in the diagnosis thereof are outlined. We discuss the role and method of shunt tapping in diagnosing shunt problems before reviewing the literature describing the rationale. The variation in shunt design is emphasized. Guidelines are then proposed not to dissuade physicians from tapping shunts but to ensure that the procedure is performed safely and in collaboration with neurosurgical units.
authors.affiliation: Department of Paediatric Neurosurgery, Radcliffe Infirmary, Oxford, UK. drmaartens@doctors.org.uk
authors.forename: N F
authors.initials: NF
authors.lastname: Maartens
authors.forename: P
authors.initials: P
authors.lastname: Aurora
authors.forename: P G
authors.initials: PG
authors.lastname: Richards
mesh_terms: D002494:Central Nervous System Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis; D002555:Cerebrospinal Fluid; D003937:Diagnosis, Differential; D003949:Diagnostic Techniques, Surgical / Q000009:adverse effects; D006801:Humans; D006849:Hydrocephalus / Q000150:complications*; D007223:Infant; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008297:Male; D019300:Medical Errors; D012141:Respiratory Tract Infections / Q000097:blood / Q000175:diagnosis; D012640:Seizures / Q000209:etiology*; D013396:Suction / Q000009:adverse effects* / Q000379:methods; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects / Q000295:instrumentation