Cranial migration of ventriculoperitoneal shunt

Abstract

We report a rare case of an 11-month male infant with cranial migration of ventriculoperitoneal (VP) shunt assembly. The shunt chamber was lying inside the ventricles. At the time of shunt revision, outsized burr hole and wide dural opening were observed. The ventricular migrated chamber of VP shunt was first retrieved from the ventricle followed by the removal of whole shunt assembly. A new VP shunt was placed on the other side with the chamber firmly anchored to the pericranium. The diagnosis was timely done and prevented complete shunt migration into the ventricles. We attribute factors such as outsized burr hole, wide dural opening, and poor anchoring of the straight connector of shunt chamber to periosteum because of poor tissue preservation (redo operation). Repeated flushing of the shunt chamber by cranial direction pressing on it by the mother might be a contributing factor for loosening of anchor sutures and cranial migration. Patients undergoing VP shunt procedure must be under regular follow-up for early recognition of this potential complication. Cranial migration of VP shunt is usually not a fatal complication.

Keywords

• Cranial
• hydrocephalus
• intraventricular
• migration
• ventriculoperitoneal shunt