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Intracranial calcified pseudocyst reaction to a shunt catheter

June Yowtak1, Douglas Hughes, Ian Heger

  • 1Department of Neurosurgery, Georgia Regents University, Augusta, Georgia.

Journal of Neurosurgery. Pediatrics
|December 17, 2013
PubMed

Insights

A rare intracranial calcified pseudocyst formed around a shunt catheter in a child with spina bifida and hydrocephalus. This case highlights a unique complication of cerebrospinal fluid shunting in pediatric neurosurgery.

Area of Science:

  • Neurosurgery
  • Pediatric Neurology
  • Medical Imaging

Background:

  • Spina bifida, Chiari II malformation, and hydrocephalus often require cerebrospinal fluid (CSF) shunting.
  • Shunt malfunction can lead to increased intracranial pressure (ICP).
  • Intracranial calcifications are a known but uncommon complication in neurosurgery.

Observation:

  • A 9-year-old boy with pre-existing neurological conditions presented with symptoms of shunt malfunction.
  • Radiological imaging identified an intracranial calcified lesion adjacent to the shunt's ventricular catheter.
  • Analysis of aspirated fluid revealed a milky white substance.

Findings:

  • Pathology confirmed dystrophic calcification and a pseudocyst formation encasing the shunt catheter.
  • This represents the first reported instance of an intracranial calcified pseudocyst in a patient with normal renal function.
  • The patient's neurological status returned to baseline after intervention.

Implications:

  • This case expands the understanding of potential complications associated with CSF shunts.
  • It underscores the importance of comprehensive histopathological examination of shunt hardware.
  • Further research may explore the specific mechanisms leading to pseudocyst formation in the absence of renal compromise.

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