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Latent abscess formation adjacent to a non-functioning intraventricular catheter
Vassilios I Vougioukas1, Friedrich Feuerhake, Ulrich Hubbe
1Department of Neurosurgery, Albert-Ludwigs University of Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany. vvougio@nz.ukl.uni-freiburg.de
Summary
A rare complication of ventriculoperitoneal (VP) shunts, an intracerebral abscess, developed 16 years after initial treatment for hydrocephalus. This case highlights delayed onset and progression in an asymptomatic patient, questioning the necessity of removing non-functioning shunts.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Infectious Diseases
Background:
- Ventriculoperitoneal (VP) shunts are standard treatment for obstructive hydrocephalus.
- Complications can arise, but extremely delayed onset is uncommon.
Observation:
- A 16-year-old male, treated for hydrocephalus with a VP shunt at 13 months, presented for routine follow-up.
- Radiological evaluation revealed an intracerebral mass adjacent to the intraventricular catheter.
- The mass, identified as an abscess, progressed over 3 years despite the patient remaining asymptomatic.
Findings:
- The case demonstrates an extremely delayed onset (16 years) of a ventriculoperitoneal shunt complication.
- The intracerebral abscess showed progressive growth in an asymptomatic patient.
- Histological classification confirmed the mass as an abscess.
Implications:
- This case underscores the potential for late-onset, progressive complications associated with VP shunt systems.
- It raises important clinical questions regarding the management and necessity of removing non-functioning shunts.
- Highlights the importance of long-term monitoring for patients with shunts, even in the absence of symptoms.