Occult cerebrospinal fluid fistula between ventricle and extra-ventricular position of the ventriculoperitoneal shunt tip.
OBJECTIVE
Ventriculoperitoneal (VP) shunt or ventriculoatrial shunt is a common operation for treatment of hydrocephalus. Usually, shunt series (plain radiographs of the skull, neck, chest and abdomen) and brain computed tomography (CT) are used to monitor the status of hydrocephalus and VP shunt. However, does the result of a brain CT really reflect the status of the hydrocephalus and shunt function? In patients with VP shunt, brain CT image only may lead to misdiagnosis of the status of the hydrocephalus and result in inadequate treatment plan.


METHODS
The authors reported a 6-year-old patient with occult cerebrospinal fluid (CSF) fistula between ventricle and extra-ventricular position of the VP shunt tip on CT scan and resulted in inappropriate shunt removal.


CONCLUSIONS
The patient was diagnosed to have shunt-dependent hydrocephalus with inadequate shunt removal. In this kind of patient, further studies may reduce unnecessary morbidity or mortality.
Department of Neurosurgery, Chang Gung University Colleage of Medicine, Taoyuan, Taiwan.
Ching-Yi
CY
Lee
Chieh-Tsai
CT
Wu
Kuang-Lin
KL
Lin
Hsun-Hui
HH
Hsu
D002648:Child; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology / Q000601:surgery*; D007427:Intracranial Pressure; D008297:Male; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*