Migration of an Entire One-Piece Shunt into the Ventricle

Abstract

Migration of an entire one-piece shunt into the lateral ventricle of a six-month-old boy is reported. This is a rare complication in this kind of shunt, and has not previously been reported.

Retrograde migration of ventriculoperitoneal shunt to the neck. Case report

“…Conan et al reported the retrograde migration of the catheter of ventriculoatrial shunts within the internal jugular vein in two adult patients 2 . Others have also documented penetration of shunts within the cerebral ventricles 1,9,10,13,14 . Most instances of this occurrence have been related with the use of unishunts and valveless systems 1,12,13 .…”

“…Others have also documented penetration of shunts within the cerebral ventricles 1,9,10,13,14 . Most instances of this occurrence have been related with the use of unishunts and valveless systems 1,12,13 . Subcutaneous coiling at the scalp adjacent to the burr-hole has also been illustrated in several cases 3,5,6,11 .…”

“…Mechanical complications, especially those related to shunt-parts disconnection and downward catheter migration have diminished with the growing use of shunts made up with soldered pieces. Although rarely, all components of the shunt systems (reservoir, valve and ventricular or distal catheters) may be displaced from their original position and migrate to diverse parts of the body [1][2][3][4][5][6][7][8][9][10][11][12][13][14] . The retrograde migration of peritoneal or venous catheters through the subcutaneous tract of the shunt tubing has been reported in several occasions [1][2][3][4][5][6][8][9][10][11][12][13][14] .…”

Ventricular migration of shunt: Chhabra shunt complication

“…[1][2][3]10,11,13,16,17,19,22 Almost all have reported such cases in malnourished infants with complicated postoperative course. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Heim and Kim have reported migration of ventriculoperitoneal shunt to subgaleal and subdural spaces. 4,5 The probable cause of retrograde migration is a much debated subject with numerous hypothesis forwarded in literature.…”

“…One of the earliest reported cases of complete Intraventricular migration of shunt systems were in 70s by Mori & Villarejo. 6,7 Mori explained the migration of shunt tubes to ventricle due to technical issues like large burr hole and wide opening of dura and poor anchorage of shunt chamber to periosteum. 6 Young described two cases and implicated excessive neck movements in infants due to seizures creating a windlass effect leading to the migration.…”