title: A rare but life-threatening complication of ventriculo-atrial shunt.
abstract: Insertion of ventriculoperitoneal and ventriculoatrial shunts is routinely performed. Infarction pneumonia and atrial thrombus formation are described as very rare complications of ventriculoatrial shunts. We present the case of a female patient with ventriculoatrial shunt insertion as long term treatment for aequeductal stenosis who presented with recurrent episodes of dyspnoea, chest pain, and unilateral pleural effusion. Diagnostic evaluation revealed a positive D-dimer test, bilateral basal infiltrates and pleural effusion. Transesophageal echocardiography established the diagnosis of a thrombus in the right atrium. Laboratory testing for thrombophilia revealed a homozygous factor V Leiden mutation. In the following, a shunt revision was performed.
authors.affiliation: Department of Emergency Psychiatry, Clinic North, Hamburg, Germany. tonn@neuro-info.de
authors.forename: P
authors.initials: P
authors.lastname: Tonn
authors.forename: J M
authors.initials: JM
authors.lastname: Gilsbach
authors.forename: I
authors.initials: I
authors.lastname: Kreitschmann-Andermahr
authors.forename: A
authors.initials: A
authors.lastname: Franke
authors.forename: R
authors.initials: R
authors.lastname: Blindt
mesh_terms: D000328:Adult; D002535:Cerebral Aqueduct / Q000473:pathology / Q000503:physiopathology; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D005165:Factor V / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology*; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012086:Reoperation; D019851:Thrombophilia / Q000235:genetics; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology
chemical_list: C095381:factor V Leiden; D005165:Factor V