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Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review
BACKGROUND: The intracranial migration of a ventriculoperitoneal shunt (VPS) has been previously described, it is a very rare event, and the mechanisms of this migration have not yet been elucidated. CASE DESCRIPTION: Newborn at 38 weeks of gestation by cesarean section, with congenital hydrocephalu...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070269/ https://www.ncbi.nlm.nih.gov/pubmed/37025522 http://dx.doi.org/10.25259/SNI_1098_2022 |
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author | Espinosa, Alejandro Ceja Navarro-Garcia de Llano, Juan Pablo Balcázar-Padrón, Juan Carlos Tafur-Grandett, Abrahan Alfonso |
author_facet | Espinosa, Alejandro Ceja Navarro-Garcia de Llano, Juan Pablo Balcázar-Padrón, Juan Carlos Tafur-Grandett, Abrahan Alfonso |
author_sort | Espinosa, Alejandro Ceja |
collection | PubMed |
description | BACKGROUND: The intracranial migration of a ventriculoperitoneal shunt (VPS) has been previously described, it is a very rare event, and the mechanisms of this migration have not yet been elucidated. CASE DESCRIPTION: Newborn at 38 weeks of gestation by cesarean section, with congenital hydrocephalus due to Dandy–Walker malformation that required right Frazier VPS placement. At 2-month follow-up, computed tomography of the skull showed cranial migration of VPS and dysfunction. At evaluation, there were signs of systemic infection. External ventricular drainage was placed and an intravenous antibiotic scheme for Gram-positive bacteria was started. After 3 months, cerebrospinal fluid cultures were negative and definitive VPS was decided. CONCLUSION: Different possible mechanisms have been proposed, such as negative intraventricular pressure, positive intra-abdominal pressure, use of valveless catheters, excessive burr hole size, as well as such as occipital ventricular access, thin cortical mantle, incorrect distal and proximal fixation, short distance between the peritoneum and ventricles, and a possible inflammatory reaction to the catheter material (silicone). A combination of these different mechanisms contributes to proximal shunt migration. Although the placement of a VPS is a procedure well taught since the 1(st) years of neurosurgical residency, it is not exempt from complications. Although, as was previously stated in this paper, the incidence of a complete cranial VPS migration is extremely rare, and only a few cases are documented, it is still important to report this type of cases and to try to elucidate the possible mechanisms involved. |
format | Online Article Text |
id | pubmed-10070269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-100702692023-04-05 Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review Espinosa, Alejandro Ceja Navarro-Garcia de Llano, Juan Pablo Balcázar-Padrón, Juan Carlos Tafur-Grandett, Abrahan Alfonso Surg Neurol Int Case Report BACKGROUND: The intracranial migration of a ventriculoperitoneal shunt (VPS) has been previously described, it is a very rare event, and the mechanisms of this migration have not yet been elucidated. CASE DESCRIPTION: Newborn at 38 weeks of gestation by cesarean section, with congenital hydrocephalus due to Dandy–Walker malformation that required right Frazier VPS placement. At 2-month follow-up, computed tomography of the skull showed cranial migration of VPS and dysfunction. At evaluation, there were signs of systemic infection. External ventricular drainage was placed and an intravenous antibiotic scheme for Gram-positive bacteria was started. After 3 months, cerebrospinal fluid cultures were negative and definitive VPS was decided. CONCLUSION: Different possible mechanisms have been proposed, such as negative intraventricular pressure, positive intra-abdominal pressure, use of valveless catheters, excessive burr hole size, as well as such as occipital ventricular access, thin cortical mantle, incorrect distal and proximal fixation, short distance between the peritoneum and ventricles, and a possible inflammatory reaction to the catheter material (silicone). A combination of these different mechanisms contributes to proximal shunt migration. Although the placement of a VPS is a procedure well taught since the 1(st) years of neurosurgical residency, it is not exempt from complications. Although, as was previously stated in this paper, the incidence of a complete cranial VPS migration is extremely rare, and only a few cases are documented, it is still important to report this type of cases and to try to elucidate the possible mechanisms involved. Scientific Scholar 2023-03-24 /pmc/articles/PMC10070269/ /pubmed/37025522 http://dx.doi.org/10.25259/SNI_1098_2022 Text en Copyright: © 2023 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Espinosa, Alejandro Ceja Navarro-Garcia de Llano, Juan Pablo Balcázar-Padrón, Juan Carlos Tafur-Grandett, Abrahan Alfonso Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review |
title | Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review |
title_full | Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review |
title_fullStr | Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review |
title_full_unstemmed | Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review |
title_short | Intracranial migration of a ventriculoperitoneal shunt: A case report and literature review |
title_sort | intracranial migration of a ventriculoperitoneal shunt: a case report and literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070269/ https://www.ncbi.nlm.nih.gov/pubmed/37025522 http://dx.doi.org/10.25259/SNI_1098_2022 |
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