Proximal Migration of Lumboperitoneal Shunt Catheter Up To Cervical Spine

Abstract

Lumboperitoneal (LP) shunt had been in use as an internal cerebrospinal fluid (CSF) diversion for a variety of different indications, namely benign intracranial hypertension, communicating hydrocephalus, slit ventricle syndrome and CSF fistulas.Generally, considered to be a simple surgical procedure, butcertain potential complications are associated with this technique, including chronic subdural hematoma, subarachnoid hemorrhage, acquired Chiari malformations and migration of the shunt tubing. 1,2 Proximal intrathecal migration of LP shunt catheter tip, high up in the cervical spine is a rare reported complication. [3][4][5][6][7][8] If doubtful on X-rays, Computed Topography (CT) scan confirms the diagnosis. Although, the multi factorial's proximal migration is usually because of a faulty technique when anchoring sutures are loosened or cut. The measures employed to avoid this potential complication include appropriate techniques for securing the LP shunt tube at the proximal lumbar and the distal peritoneal insertion sites with suture collars, thus enabling fixation of the tube. We report a case of an obese middle age female who developed proximal migration of the lumbar tube up to the cervical spine, after having undergone LP shunt for pseudotumor cerebri.