Ventriculopleural Shunt Dysfunction Due to a Loculated Pleural Collection Demonstrated on SPECT/CT Imaging

Abstract

A 35-year-old woman presented with increasing drowsiness on a background of childhood meningitis and hydrocephalus managed with a ventriculopleural shunt. Her cerebral CT and chest radiograph were unchanged from previous imaging and did not identify significant pathology. Because of clinical suspicion of cerebrospinal fluid shunt dysfunction, she was referred for a cerebrospinal fluid shunt study, which demonstrated tracer accumulation within a loculated pleural collection in the left costophrenic recess.

Shunt-Bronchial Fistula with Coughing Up and Swallowing of Cerebrospinal Fluid: Rare Complication of Ventriculopleural Shunt

“…Distal shunt infections can manifest in various ways in addition to shunt malfunction: thoracic empyema or pleural effusions/pseudocysts in the setting of ventriculopleural shunts, abdominal pseudocysts or peritonitis with VP shunts, or bacteremia with ventriculoatrial shunts 35, 36, 37, 38. CSF should be sampled, and if possible the fluid collections at the distal site should be aspirated.…”