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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Syndrome of overdrainage associated with disconnection of a ventriculoperitoneal shunt

G Rosenthal1, S Pomeranz, S Spektor

  • 1Department of Neurosurgery, Hadassah University Hospital, Jerusalem, Israel.

Pediatric Neurosurgery
|March 9, 2000
PubMed

Insights

A child experienced cerebrospinal fluid (CSF) overdrainage due to a disconnected shunt valve, leading to slit-like ventricles. Upgrading the shunt resolved the symptoms, suggesting a patent fibrous tract facilitated excessive CSF drainage.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Medical Device Technology

Background:

  • Hydrocephalus management often involves cerebrospinal fluid (CSF) shunts.
  • Shunt malfunction is a common complication, requiring timely diagnosis and intervention.
  • Overdrainage is a potential complication of CSF shunts, leading to characteristic radiological findings.

Observation:

  • A pediatric patient presented with symptoms suggestive of CSF overdrainage.
  • Computed tomography (CT) revealed slit-like ventricles, a hallmark of reduced intracranial pressure.
  • The distal shunt valve was found to be disconnected, indicating a hardware failure.

Findings:

  • The disconnected distal shunt valve led to excessive CSF drainage, causing the overdrainage syndrome.
  • A patent fibrous tract was identified as a potential pathway facilitating the abnormal CSF flow.
  • Surgical upgrade of the shunt system successfully resolved the patient's symptoms and normalized ventricular size.

Implications:

  • This case highlights the importance of considering shunt disconnection in pediatric patients with overdrainage symptoms.
  • The presence of a patent fibrous tract may predispose to overdrainage even with apparent shunt malfunction.
  • Prompt recognition and management of shunt complications are crucial for favorable neurological outcomes in children.

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