Complete Intraventricular Migration of Ventriculoperitoneal Shunt: Once in a Blue Moon Phenomenon of Shunt Surgery

IF 0.3 Q4 SURGERY Indian Journal of Neurosurgery Pub Date : 2023-12-21 DOI:10.1055/s-0043-1777278
Vikrant Yadav, Ravi Shankar Prasad
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Abstract

Abstract Shunt surgery is a very common neurosurgical procedure for hydrocephalus. It is associated with numerous complications, and intraventricular shunt migration is one of rarest. Various mechanisms have been described to explain this rare entity. Hereby we present an index case of this rare complication of shunt surgery in which patient presented with tuberculous meningitis with hydrocephalus having intraventricular shunt migration and will discuss possible mechanisms responsible for it. A 1-year old male infant, previously diagnosed case of tuberculous meningitis with hydrocephalus with right-sided ventriculoperitoneal shunt in situ, presented to the emergency department with bulging fontanelles secondary to shunt malfunction. Left-sided ventriculoperitoneal shunt was inserted. After few months, patient turned up again with left-sided shunt malfunction and right-sided intraventricular migrated shunt. Endoscopy-assisted removal of intraventricular migrated shunt and simultaneous third ventriculostomy was done. Patient improved in postoperative period. Being an extremely uncommon complication, intraventricular migration of shunt described as “once in a blue moon” phenomenon. It can be avoided by proper surgical technique with adequate-sized burr hole. Removal of shunt is preferred for prevention of infection.
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脑室腹腔分流术的完全室内移位:分流手术中罕见的蓝月亮现象
摘要 分流手术是治疗脑积水的一种非常常见的神经外科手术。它与许多并发症相关,而脑室内分流管移位是最罕见的并发症之一。对于这种罕见的并发症,有多种解释机制。在此,我们介绍一例分流手术罕见并发症的病例,患者因结核性脑膜炎伴脑积水而出现脑室内分流管移位,并将讨论造成这种并发症的可能机制。一名 1 岁男婴曾被诊断为结核性脑膜炎伴脑积水,并在原位进行了右侧脑室腹腔分流术,因分流术故障导致囟门膨出而到急诊科就诊。患者接受了左侧脑室腹腔分流术。几个月后,患者再次出现左侧分流管故障和右侧脑室内分流管移位。在内窥镜辅助下,患者的脑室内移位分流管被移除,同时进行了第三脑室造口术。患者术后情况好转。作为一种极为罕见的并发症,分流管室内移位被描述为 "蓝月亮里的一次 "现象。正确的手术技巧和足够大小的毛刺孔可以避免这种情况。为防止感染,最好切除分流管。
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
52
审稿时长
12 weeks
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