CASE REPORTS   

Journal of Neurosurgical Sciences 2002 June;46(2):100-3

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Extremely rare complications in cerebrospinal fluid shunt operations

Surchev J., Georgiev K., Enchev Y., Avramov R.

Clinic of Pediatric Neurosurgery, Department of Neurosurgery, Medical University of Sofia, Sofia, Bulgaria

The cere­bro­spi­nal ­fluid ­shunt oper­a­tion, ­from its ­first real­iza­tion in 1908 by Kausch ­till our ­days, is ­still of a sig­nif­i­cant impor­tance for the ­long-­term treat­ment of the inter­nal hydro­ceph­a­lus. Well ­known are ­many com­pli­ca­tions con­nect­ed ­with the use of the ­valve ­systems (mal­func­tion, infec­tious, over­drain­age, sec­on­dary cran­i­os­y­nos­to­sis and etc.). For a peri­od of 17 ­years (1984-2000) at the Clinic of Pediatric Neurosurgery, Department of Neurosurgery, Sofia Medical University, 414 cere­bro­spi­nal ­fluid ­shunt oper­a­tions ­were per­formed on chil­dren. 216 ­were ­drained to the ­right atri­um of the ­heart, 198 to the per­i­to­neal cav­ity. They ­were fol­lowed up by catam­ne­sis ­until the ­year 2001. The ­authors ­describe 2 extreme­ly ­rare cas­es ­with ­post-­shunt com­pli­ca­tion as a ­result of a mal­func­tion of the ­valve ­system, ­owing to a migra­tion of the dis­tal cath­e­ter: 1) in the ­anus; 2) in the ure­thra. In the ­first ­case the dis­tal cath­e­ter per­fo­rat­ed the ­colon trans­ver­sum and by the way of the intes­tines ­went out ­through the ­anus. In the sec­ond ­case the dis­tal cath­e­ter pro­trud­ed out of the ­body ­through the blad­der and the ure­thra. Their clin­i­cal appear­ance, the diag­nos­tic exam­ina­tions and the oper­a­tive treat­ment are ­shown.