Chronic overshunting

Case contributed by Frank Gaillard
Diagnosis almost certain


Morning headaches.

Patient Data

Age: 50 years
Gender: Male

Right parietal shunt with two tubes crossing the midline with the tips in the anterior horn of the left lateral ventricle. Encephalomalacia in the right parietal lobe at the shunt entry point. 

The lateral ventricles are slit like and the third ventricle is small. There are bilateral densely calcified subdural collections. The features suggest chronic/long-standing over shunting.

Case Discussion

In the acute setting, overshunting can produce subdural effusions and hemorrhages. If chronic these collections can calcify. 

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