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Updated: Sep 23, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Shunt malfunction caused by mischievous twisting of the valve by the patient: case report
Shinya Nabika1, Shuichi Oki, Masayuki Sumida
1Department of Neurosurgery, Hiroshima City Asa Hospital, Hiroshima, Japan. noge@asa-hosp.city.hiroshima.jp
Objective And Importance:
We report an instructive case of repetitive shunt obstruction caused by mischievous turning of the valve by the patient.
Clinical Presentation:
A 7-year-old boy underwent shunt replacement for hydrocephalus caused by intraventricular hemorrhage at birth; the shunt had been revised a month earlier. The boy experienced occasional episodes of headache and vomiting after the revision. A shunt survey revealed a twisted tube just proximal to the valve.
Intervention:
After the valve was returned to its original position, the symptoms resolved. The patient confessed to a recent habit of turning the valve.
Conclusion:
Although turning of the valve may be a potential cause of shunt obstruction, the use of craniography and/or a shunt series should be able to reveal these changes.
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