Bilateral papilledema as the first sign of ventriculoperitoneal shunt dysfunction§

Area of Science:

• Neuroscience
• Ophthalmology
• Pediatric Medicine

Background:

• Ventriculoperitoneal shunts are common treatments for hydrocephalus in children.
• Shunt malfunction can lead to serious neurological complications.
• Ophthalmologic findings are sometimes associated with increased intracranial pressure.

Purpose of the Study:

• To report a case of pediatric ventriculoperitoneal shunt dysfunction presenting initially with visual decline.
• To emphasize the importance of considering shunt issues in children with unexplained visual disturbances.

Main Methods:

• Case report of a 12-year-old female patient.
• Review of clinical presentation, ophthalmologic examination, and diagnostic work-up.
• Correlation of symptoms with ventriculoperitoneal shunt status.

Main Results:

• The patient presented with progressive bilateral decreased visual acuity and bilateral papilledema.
• No other systemic signs of increased intracranial pressure were observed.
• Laboratory tests ruled out infectious or inflammatory causes.

Conclusions:

• Ophthalmologic manifestations, specifically papilledema and decreased visual acuity, can be the initial presenting signs of ventriculoperitoneal shunt dysfunction.
• Early recognition of these visual changes is crucial for timely diagnosis and management of shunt complications in pediatric patients.