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Intracranial perishunt fluid collection with edema

Case contributed by Henry Knipe
Diagnosis probable

Presentation

New left sided weakness.

Patient Data

Age: 50 years
Gender: Female

Right parietal approach ventricular drain. Extensive vasogenic cerebral edema in the right parietal lobe with very hypodense component adjacent to the drain. 

Right parietal approach ventricular drain. Extensive vasogenic cerebral edema in the right parietal lobe centered on the drain. Centrally in the right parietal lobe edema is a fluid collection that follows CSF-intensity on all sequences. Thin, linear contrast enhancement along the intracranial portion of the drain. 

Case Discussion

The patient had a history of meningioma resection complicated by symptomatic hydrocephalus for which she underwent ventriculoperitoneal shunting. After imaging, the patient underwent removal of the shunt with no gross failure noted. The shunt was returned to the manufacturer for a detailed assessment. 

Intracranial perishunt fluid collections with edema is an uncommon complication of ventriculoperitoneal shunt insertion and are considered a sign of shunt malfunction. 

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