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Case report
Case of penetrating brain injury caused by a ventriculoperitoneal shunting procedure
  1. Yuzaburo Shimizu,
  2. Mario Suzuki,
  3. Osamu Akiyama and
  4. Akihide Kondo
  1. Department of Neurosurgery, Juntendo University, Tokyo, Japan
  1. Correspondence to Dr Akihide Kondo; knd-aki{at}juntendo.ac.jp

Abstract

Brain injury with ventricle puncture is a well-known complication of ventriculoperitoneal (VP) shunting. However, parenchymal injuries caused by a shunt tunneller are rare. Herein, we present a case of penetrating brain injury caused by a shunt tunneller during VP shunting. An 83-year-old woman with brainstem glioma underwent VP shunting to control hydrocephalus due to tumour growth. She underwent brainstem tumour biopsy with a lateral suboccipital approach. After the shunting, CT showed a linear haematoma in the left occipital lobe far from the site of the ventricular puncture. MRI revealed a small contusion in the left cerebellar hemisphere, disconnection of the left tentorial membrane and linear haematoma on a straight line. These facts suggested that the shunt tunneller had penetrated the skull through the craniotomy of the posterior fossa. This is a rare complication of VP shunting, with limited cases reported in the literature.

  • hydrocephalus
  • neurosurgery

https://doi.org/10.1136/bcr-2020-241392

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    Footnotes

    • Contributors YS: substantial contributions to the the work; or the acquisition, analysis or interpretation of data for the work. MS: revising it critically. OA: revising it critically. AK: agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.