Acute shunt malfunction after cesarean section delivery: a case report

Area of Science:

• Neurosurgery
• Obstetrics
• Neurology

Background:

• Shunt malfunctions requiring surgery during pregnancy or postpartum are uncommon.
• No prior reports exist on acute shunt malfunction immediately following cesarean section.

Observation:

• A 32-year-old woman presented with drowsiness 12 hours postpartum after a cesarean section.
• She had a history of ventriculoperitoneal shunt placement for hydrocephalus secondary to meningitis.
• Brain CT revealed significant ventriculomegaly; temporary consciousness improvement followed CSF aspiration.

Findings:

• Surgical exploration identified a blood clot obstructing the distal catheter tip of the ventriculoperitoneal shunt.
• The obstruction is presumed to be caused by intraoperative bleeding during the cesarean section.
• The distal catheter was resected, and the remaining portion was repositioned in the peritoneal cavity.

Implications:

• This case highlights a rare but serious complication of ventriculoperitoneal shunts in the immediate postpartum period after cesarean delivery.
• Prompt diagnosis and surgical management are crucial for favorable outcomes.
• Further vigilance is warranted for patients with shunts undergoing cesarean delivery.