Intraparenchymal pericatheter cyst following disconnection of ventriculoperitoneal shunt system

• Main Authors: S Balasubramaniam, D K Tyagi, H V Sawant
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Journal of Postgraduate Medicine
• Subjects: Intraparenchymal pericathter cyst; porencephalic cyst; ventriculoperitoneal shunt
• Online Access: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2013;volume=59;issue=3;spage=232;epage=234;aulast=Balasubramaniam

Ventriculoperitoneal (VP) shunt is one of the most commonly performed procedures in neurosurgery, but it is also the procedure, which is most prone to complications. Spread of cerebrospinal fluid (CSF) into the brain parenchyma is a rare complication of VP shunt and can take the form of CSF edema or a porencephalic cyst. We describe a case of a 1½-year-old child who presented to us with seizures. Computed tomography scan revealed pericatheter porencephalic cyst. Surgical exploration revealed a disconnected VP shunt system. Patient was neurologically observed after shunt extraction. He was seizure free and radiological follow-up showed resolution of cyst. Ours is the first case to document the presence of pericatheter cyst following complete disconnection of shunt system. Though shunt revision is the accepted treatment modality, careful neurological observation can be done after shunt removal especially in asymptomatic cases with compensated hydrocephalus.