Complete intraventricular migration of ventriculo-peritoneal shunt: A rare case report. (December 2022)

• Record Type: Journal Article
• Authors: Deo, Ram Chandra; Acharya, Abhijit; Senapati, Satya Bhusan; Panigrahi, Souvagya; Mohapatra, Ashok Kumar
• Is Part Of: International journal of surgery case reports. Volume 101(2022)
• Publication Date: 2022-12
• Subjects: Shunt migration -- Shunt complications -- Hydrocephalous -- Rare surgical case; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107772
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: A ventriculoperitoneal (VP) shunt is a cerebral shunt used to treat hydrocephalus. This is used to remove the excessive accumulation of cerebrospinal fluid inside the ventricles. Case presentation: We are reporting a rare case of complete intracranial migration of a ventriculoperitoneal shunt, a potentially fatal complication, presenting to us with hydrocephalous. The baby was taken up for surgery with endoscopic assisted shunt removal and shunt revision. Clinical discussion: Ventriculoperitoneal shunt is one of the common procedures used in infants and children, however, it is used in all age groups for hydrocephalous. The shunt is associated with multiple large number of complications like obstruction, infection, migration, and separation from the connected site. Etc. Shunt migration is a less common complication of which cranial migration is still less common. Conclusion: Optimum creation of the sub-galeal space for the shunt chamber, a smaller burr hole, a smaller dural opening, and proper anchorage of the chamber to the pericranium, are some of the measures that may be useful in obviating this complication. Highlights: Incidence of complete intracranial migration was reported to be 0.1–0.4% of the total shunt-related complications with the earliest report of intracranial migration in 1955. Our patient was a unique case of complete intracranial migration of a ventriculoperitoneal shunt into the ventricle after 4 months of surgery for myelomeningocele The case was managed by endoscopic removal of the migrated shunt with new shunt placement was done Optimum creation of the subgaleal space for the shunt chamber, a smaller burr hole, a smaller dural opening, and proper anchorage of the chamber to the pericranium, are some of the measures taken Hence, for any case of prior shunt insertion with hydrocephalus in infants, the rare possibility of intracranial shunt migration should be considered a possibility.