Journal of Pediatric Neurosciences
LETTER TO THE EDITOR
Year
: 2011  |  Volume : 6  |  Issue : 1  |  Page : 88--89

Total migration of a ventriculo-peritoneal shunt catheter into the ventricles


Amit Agarwal, Anand Kakani 
 Department of Neurosurgery, Datta Meghe Institute of Medical Sciences, Sawangi, Meghe, Wardha, Maharashtra, India

Correspondence Address:
Amit Agarwal
Department of Neurosurgery, Datta Meghe Institute of Medical Sciences, Sawangi, Meghe, Wardha - 442 004, Maharashtra
India




How to cite this article:
Agarwal A, Kakani A. Total migration of a ventriculo-peritoneal shunt catheter into the ventricles.J Pediatr Neurosci 2011;6:88-89


How to cite this URL:
Agarwal A, Kakani A. Total migration of a ventriculo-peritoneal shunt catheter into the ventricles. J Pediatr Neurosci [serial online] 2011 [cited 2021 Jan 21 ];6:88-89
Available from: https://www.pediatricneurosciences.com/text.asp?2011/6/1/88/84421


Full Text

Dear sir,

Complete proximal migration of an entire ventriculo-peritoneal shunt into the ventricles is a rare complication. [1],[2],[3] A 10-month-old male child underwent right ventriculo-peritoneal shunt for congenital hydrocephalus at the age of 6 months. He was doing apparently well after surgery until the mother noticed an increase in the size of the head about 1 month back. Computed tomography (CT) scan showed the coiling of the shunt in the ventricular system and persistence of ventriculomegaly [Figure 1]. X-ray skull lateral view showed complete migration of the shunt system into the ventricles [Figure 2]. The shunt revision was performed and the child is doing well. Cephalad migration requires a potential space (subgaleal or ventricular) and no resistance to movement of the tubing, and mechanism of upward migration of the entire length of distal shunt catheter probably involves patient motion that creates a "windlass" effect. [2],[4] Several other mechanisms contributing to the migration of the shunt tubing have been proposed and these include negative sucking intraventricular pressure, positive pushing intra-abdominal pressure, tortuous subcutaneous track and neck movements. [1] Further, a large dural hole around the ventricular catheter may predispose to periventricular CSF collection and easy proximal migration of the valve system. [4],[5] It has been suggested that this complication can be prevented by securing the shunt near the site of motion. [2]{Figure 1}{Figure 2}

References

1Eljamel MS, Sharif S, Pidgeon CN. Total intraventricular migration of unisystem ventriculo-peritoneal shunt. Acta Neurochir (Wien) 1995;136:217-8.
2Heim RC, Kaufman BA, Park TS. Complete migration of peritoneal shunt tubing to the scalp. Childs Nerv Syst 1994;10:399-400.
3Sharma S, Gupta DK. Intraventricular migration of an entire vp shunt. Indian Pediatr 2005;42:187-8.
4Kim KJ, Wang KC, Cho BK. Proximal migration and subcutaneous coiling of a peritoneal catheter: Report of two cases. Childs Nerv Syst 1995;11:428-31.
5Chauhan H, Jain R, Rath G, Prabhakar H. Upward migration and subcutaneous coiling of the ventriculo-peritoneal shunt catheter: A case report. Internet J Neurosurg 2006:3.