Related Experiment Videos
Delayed complication of Matson operation for hydrocephalus: case report
Neurosurgery
|September 1, 1981
Summary
A shunt malfunction caused increased intracranial pressure in a hydrocephalus patient, leading to neurological decline. Prompt diagnosis and a new shunt resolved the condition, averting a poor outcome.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Infectious Disease
Background:
- A 26-year-old woman with a history of hydrocephalus treated with a lumbar subarachnoid-ureteral shunt since infancy.
- Developed meningitis secondary to urinary tract infection with reflux, necessitating shunt removal.
Observation:
- Post-shunt removal, the patient experienced clinical deterioration, including altered consciousness, headaches, and midbrain dysfunction.
- Serial computed tomography scans revealed normal ventricular size, yet spinal puncture indicated markedly elevated intracranial pressure.
Findings:
- The patient presented with elevated intracranial pressure despite normal ventricular dimensions, a condition not immediately apparent on imaging.
- A lumboperitoneal shunt insertion led to immediate and sustained clinical improvement.
Implications:
- Highlights the importance of considering elevated intracranial pressure even with normal-appearing ventricles on imaging.
- Emphasizes prompt recognition and management of shunt complications and associated neurological deterioration.
- Demonstrates the efficacy of lumboperitoneal shunting in managing complex hydrocephalus cases with elevated intracranial pressure.