Presentation
Neurological impairment
Patient Data
Intra-axial VP shunt is noted with its tip located in the anteroinferior region of the left frontal lobe.
Significant dilatation of lateral and third ventricles is noted.
The fourth ventricle is compressed and elongated.
Inferior displacement of cerebellar tonsils, vermis and inferior aspect of the medulla is noted in the upper cervical canal. Tectal beaking is noted.
Case Discussion
The features are compatible with Chiari II malformation.
VP shunt was applied to the patient, however followup MRI showed malpositioned VP shunt at the anteroinferior region of left frontal lobe with persistent tri-ventricular hydrocephalus.
Ultrasound was performed for the patient showing bilateral hydronephrosis and hydroureter with trabeculated urinary bladder. These findings could be secondary to neurogenic bladder.
This case is also contributed by Dr. Mohammad Tahir Aien
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