Lipomatous Dural Metaplasia Associated With Chronic Ventricular Shunting: A Report of Two Cases

Ventriculoperitoneal (VP) shunting is a critical intervention for managing hydrocephalus through cerebrospinal fluid (CSF) diversion. This report presents two rare and previously undocumented cases in which patients with long-standing VP shunts developed extensive dural fat accumulation, as evidenced by computed tomography (CT) and magnetic resonance imaging (MRI). These findings are highly suggestive of lipomatous dural metaplasia - a phenomenon that remains largely unaddressed in current medical literature. These cases are notable for their distinctive imaging features and the exclusion of alternative diagnoses, offering a compelling basis for further inquiry. By documenting these unique presentations, this manuscript aims to raise awareness and stimulate research into the pathophysiology, clinical implications, and diagnostic criteria of dural fat accumulation associated with chronic CSF shunting.