Abnormal VP shunt series

Case contributed by Dr Yusra Sheikh

Presentation

Background of hydrocephalus, presented with vomiting. Has a VP shunt in situ.

Patient Data

Age: 20 years
Gender: Female
X-ray

The VP shunt on the right side of the neck, seen best on the lateral neck/skull and AP neck views appears discontinuous. The shunt is not seen on the chest or abdominal wall with the remainder of the tubing coiled in the abdomen.

Case Discussion

Shunt dysfunction (e.g. blockage, disconnection, kink) should always be suspected in patients who present with symptoms and signs of intracranial hemorrhage. If the initial shunt series is negative, CT should be considered to detect an occult break. 

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