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Updated: Jul 20, 2026
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Cranial migration of complete ventriculo-peritoneal shunt assembly
Trimurti D Nadkarni1, Ram K Menon, Nitin N Dange
1Department of Neurosurgery, King Edward Memorial Hospital, Seth G.S. Medical College, Parel, Mumbai 400 012, India. tdnadkarni@hotmail.com
Summary
A rare complication occurred when a pediatric patient
Area of Science:
- Pediatric Neurosurgery
- Neurological Surgery
- Medical Device Complications
Background:
- Congenital hydrocephalus, often caused by aqueduct stenosis, requires cerebrospinal fluid (CSF) diversion.
- Ventriculo-peritoneal (VP) shunts are commonly used to treat hydrocephalus in infants.
- Shunt malfunction and migration are known, but rare, complications in neurosurgery.
Observation:
- A 10-month-old male infant with severe congenital hydrocephalus experienced complete cranial migration of the entire ventriculo-peritoneal (VP) shunt.
- The entire shunt assembly, including the reservoir, was found within the dilated cerebral ventricles.
- The intraventricular shunt was intentionally left in place, and a new VP shunt was inserted contralaterally.
Findings:
- Complete intraventricular migration of a VP shunt is an exceptionally rare event.
- The case highlights the potential for significant cephalad migration of shunt components.
- The migrated shunt was managed conservatively by leaving it in situ.
Implications:
- Preventive measures include secure anchoring of shunt components to the periosteum.
- Minimizing burr hole and dural opening sizes may reduce the risk of shunt migration.
- Understanding migration mechanisms is crucial for improving VP shunt design and surgical techniques.
