Complete migration of peritoneal shunt tubing to the scalp

The entire length of distal tubing from a ventriculoperitoneal shunt was found to have migrated into the subgaleal space, and resulted in a shunt obstruction. Upward migration of distal shunt catheters has rarely been reported, but probably involves patient motion that creates a "windlass" effect. Cephaled migration requires a potential space (subgaleal or ventricular) and no resistance to movement of the tubing. This complication can be prevented by securing the shunt near the site of motion.