Presentation
Several weeks of confusion and gait disturbance with previous ventriculoperitoneal shunt.
Patient Data
Marked surrounding area of hypodensity to left parietal approach ventriculoperitoneal shunt.
Right cerebellar encephalomalacia and overlying craniotomy.
A portion of shunt in proximity to the inner-table of the skull appears disconnected. Around this area of stent fracture a 3.2 x 1.4 cm fluid pocket has formed with marked surrounding vasogenic edema.
Case Discussion
This case demonstrates an intraparenchymal pericatheter cyst, a rare complication of ventriculoperitoneal shunt failure, with few case reports.
Initially thought to represent encephalomalacia secondary to old infarct. MRI in fact demonstrates a well defined pocket of cerebrospinal fluid around the point of shunt disconnection. Patient underwent neurosurgery for a successful ventriculoperitoneal shunt replacement. Intraoperatively the ventricular catheter was found disconnected from the valve.
Important complication for radiologists to be aware of.
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