Radiography of hydrocephalus after total parenteral nutrition

Area of Science:

• Pediatric Medicine
• Neurology
• Radiology

Background:

• Total parenteral nutrition (TPN) is a critical intervention for infants unable to achieve adequate nutrition orally.
• Jugular vein catheterization is a common route for TPN administration in infants.
• Hydrocephalus is a serious neurological condition characterized by excess cerebrospinal fluid (CSF) accumulation.

Observation:

• An infant with chronic diarrhea presented with hydrocephalus after TPN via jugular vein catheterization.
• Serial imaging revealed progressive communicating hydrocephalus.
• Sinography demonstrated bilateral internal jugular vein occlusion with collateral venous pathways.

Findings:

• TPN via jugular vein catheterization was associated with internal jugular vein occlusion.
• The vein occlusion led to the development and progression of communicating hydrocephalus.
• A lumboperitoneal shunt effectively managed the elevated CSF pressure.

Implications:

• This case highlights a potential complication of TPN through jugular vein catheterization in infants.
• Radiographic techniques like CT and sinography are crucial for diagnosing this condition.
• Careful consideration of alternative venous access routes for TPN is warranted to mitigate risks.