title: Extreme night bradycardia developing after malfunction of a lumboperitoneal shunt.
abstract: METHODS
  An 8-year-old boy who was treated for hydrocephalus with lumboperitoneal shunting presented with extreme night bradycardia.
  
  
  CONCLUSIONS
  The night bradycardia disappeared after shunt revision, suggesting that the probable cause was secondary to long-lasting increased intracranial pressure (ICP). Long-lasting increased ICP is known to be associated with papilledema, but it has rarely been reported to induce night bradycardia in clinical practice. Extreme night bradycardia in this setting is not only a clinical sign of increased ICP but also a possible cause of cardiogenic sudden death, which must be borne in mind in the management of patients with shunted hydrocephalus.
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Ohkubo Hospital, 2-44-1, Kabukicho, Shinjuku-ku, Japan. ntakeda@ohkubo-hp.metro.tokyo.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Takeda
authors.forename: Akihiro
authors.initials: A
authors.lastname: Oikawa
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Aoki
mesh_terms: D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D010211:Papilledema / Q000209:etiology; D011183:Postoperative Complications; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed