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Cranial Screw Migration along the Subdural Peritoneal Shunt Catheter in a Pediatric Patient
Buse Baykoca-Arslan1, Muhittin Belirgen2
1Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, Texas, United States.
Insights
A titanium screw loosened after pediatric craniotomy migrated with a subdural peritoneal shunt. This rare case highlights potential long-term complications of cranial fixation materials.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Biomaterials
Background:
- Craniotomy involves skull bone flap fixation, often with materials prone to long-term migration.
- Subdural peritoneal (SP) shunts are used to manage cerebrospinal fluid, and their components can also be subject to displacement.
Observation:
- A 7-year-old boy with a history of craniotomy and SP shunt experienced shunt malfunction.
- Diagnostic imaging revealed a loosened titanium screw had migrated from the skull along the SP shunt catheter.
Findings:
- The titanium screw migrated subcutaneously from the cranial fixation site, traveling along the SP shunt tubing into the abdominal wall.
- This represents the first reported pediatric case of a fixation screw migrating along an SP shunt catheter.
Implications:
- Highlights the potential for delayed complications and hardware migration years after cranial surgery in pediatric patients.
- Underscores the importance of considering material integrity and fixation security in long-term craniotomy outcomes.
- Suggests vigilance for unusual migration patterns of surgical hardware in patients with implanted devices.
Abstract:
Craniotomy is a common surgery used to expose the brain by removing a part of the bone from the skull. During surgery, bone flaps can be fixed by using variety of materials that can migrate in the long term. A 7-year-old boy presented several years after the craniotomy and subdural peritoneal (SP) shunt surgeries. It was decided to remove the shunt catheter, and during the diagnostic tests, we saw that a loosened titanium screw has migrated along the SP shunt catheter from the skull into the abdominal wall. To the best of our knowledge, this is the first case in the reported electronic literature for a pediatric patient with a subcutaneous migration of a screw along the shunt catheter.
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