A pediatric case of upward migration of distal shunt catheter followed by outward migration of ventricular catheter.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Child's Nervous System Pub Date : 2025-04-23 DOI:10.1007/s00381-025-06794-5

Keisuke Murofushi, Satoshi Tsutsumi, Natsuki Sugiyama, Hideaki Ueno, Hidehiro Okura, Hisato Ishii

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Abstract

Introduction: Catheter migration and coiling are rare complications of ventriculoperitoneal shunt (VPS).

Case report: A 4-month-old girl presented with poor feeding and vomiting. At presentation, the patient showed sunset phenomenon and tense fontanelles. Magnetic resonance imaging revealed tetraventricular dilation.

Results: The patient underwent right VPS and was discharged on postoperative day (POD) 8. She visited hospital 33 days later, with considerable swelling in the right frontoparietal region. Radiography revealed upward VPS catheter migration and coiling. The patient underwent shunt revision and was discharged on POD 8. However, 12 days later, she returned to hospital with frequent vomiting. Neuroimaging revealed an outward migration of the ventricular catheter. The patient underwent shunt revision again, which was complicated by meningitis. After resolution of it, a left VPS was installed.

Conclusions: VPS catheters installed in loose pediatric connective tissues are influenced by many factors that may cause an unexpected catheter migration.

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小儿远端分流管上移后心室导管外移一例。

导言：导管移位和盘绕是脑室腹腔分流术（VPS）的罕见并发症。病例报告：一名4个月大的女婴表现为进食不良和呕吐。患者就诊时出现日落现象和囟门紧张。磁共振成像显示心室扩张。结果：患者行右侧VPS，术后1天（POD）出院。33天后就诊，右侧额顶区明显肿胀。x线摄影显示VPS导管向上移动和盘绕。患者接受分流术翻修，并于POD 8出院。然而，12天后，她因频繁呕吐返回医院。神经影像学显示心室导管向外移位。患者再次行分流翻修术，并发脑膜炎。解决后，安装左侧VPS。结论：儿童疏松结缔组织内放置的VPS导管受到多种因素的影响，可能导致导管意外移位。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.