Intraparenchymal CSF Pseudocyst: An Unusual Complication of Ventriculoperitoneal Shunt

Alexander Lam and Peter Y.C Gan

Department of Neurosurgery, Waikato Hospital, New Zealand

^*Correspondance to: Alexander Lam 

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Abstract:

Idiopathic Intracranial Hypertension (IIH) is most commonly seen in obese women between the ages of 20 and 44 years. Patients are initially managed conservatively with dietary modifications and medical treatment. Surgical intervention such as ventriculoperitoneal shunt is usually reserved for patients with progressive deterioration of vision despite maximal medical therapy. Here we report a rare complication in a 25-year-old female who underwent ventriculoperitoneal shunt for IIH. Her symptoms improved initially following the procedure. However, she was readmitted a month later with acute worsening of symptoms and CT brain revealed a right occipito-parietal intraparenchymal cystic lesion of CSF density along the track of the ventricular catheter. The shunt was therefore removed and intraoperatively the peritoneal catheter was found to be obstructed. Culture of CSF and catheter samples were negative for infection. A new ventriculoperitoneal shunt was subsequently performed on the left side and her symptoms improved again immediately following surgery. To the best of our knowledge, this is the first reported case of an intraparenchymal CSF pseudocyst associated with ventriculoperitoneal shunt in the context of IIH and the third reported case of such complication in adult patients. We believe that the raised intracranial pressure and the blocked peritoneal catheter had synergistically resulted in the shunting of CSF from the ventricle into the interstitial space.

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Cite the Article:

Lam A, Gan PYC. Intraparenchymal CSF Pseudocyst: An Unusual Complication of Ventriculoperitoneal Shunt. Ann Clin Case Rep. 2016; 1: 1186.