Silicone hypersensitivity necessitating removal of ventriculoperitoneal shunt in schizencephaly patient complicated with hydrocephalus: A case report

Abstract

Introduction: Allergic reaction to shunt material is rarely encountered. We report a case of hypersensitivity to silicone-based shunt material that did not subside with corticosteroid which required shunt removal. Case presentation: A 5 years old child with spastic quadriplegic cerebral palsy was brought to our ER due to loss of consciousness. Physical examination revealed anisocoria of the pupils (2 mm / 7 mm) and Glasgow Coma Scale score of E2VxM3. Head computed tomography (CT) scan showed a fluid collection in the frontotemporal region and the appearance of schizencephaly. Conclusion: Allergic reaction to silicone in ventriculoperitoneal shunt material is extremely rare. Polyurethane-based tubes are usually used as a substitution for silicone tubes. However, these tubes were not available and were not covered by insurance in Indonesia. Ventriculostomy is another option for selected cases.