Occult cerebrospinal fluid fistula between ventricle and extra-ventricular position of the ventriculoperitoneal shunt tip
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Updated: May 28, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Ching-Yi Lee1, Chieh-Tsai Wu, Kuang-Lin Lin
1Department of Neurosurgery, Chang Gung University Colleage of Medicine, Taoyuan, Taiwan.
Purpose:
Ventriculoperitoneal (VP) shunt or ventriculoatrial shunt is a common operation for treatment of hydrocephalus. Usually, shunt series (plain radiographs of the skull, neck, chest and abdomen) and brain computed tomography (CT) are used to monitor the status of hydrocephalus and VP shunt. However, does the result of a brain CT really reflect the status of the hydrocephalus and shunt function? In patients with VP shunt, brain CT image only may lead to misdiagnosis of the status of the hydrocephalus and result in inadequate treatment plan.
Case Report:
The authors reported a 6-year-old patient with occult cerebrospinal fluid (CSF) fistula between ventricle and extra-ventricular position of the VP shunt tip on CT scan and resulted in inappropriate shunt removal.
Conclusion:
The patient was diagnosed to have shunt-dependent hydrocephalus with inadequate shunt removal. In this kind of patient, further studies may reduce unnecessary morbidity or mortality.
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