Presentation
Congenital hydrocephalus managed by ventriculo-peritoneal shunt, with recent onset persistent fever.
Patient Data
Diffuse marked supratentorial hydrocephalus with smooth enhancement of the ependymal lining of both lateral ventricles, small dependent fluid-fluid levels in both lateral ventricles posteriorly with a small septum on the left. Findings are suggestive of an intraventricular inflammatory process with ependymitis.
Ventriculo-peritoneal shunt catheter tip is seen at the right lateral ventricle.
Diffuse secondary parenchymal thinning and atrophy with no evidence of periventricular CSF permeation.
There are deficient mid-line structures with communicating lateral ventricles, likely due to agenesis of the corpus callosum.
Case Discussion
Secondary ventriculitis as a complication of ventriculo-peritoneal shunt with typical findings of smooth enhancement of the ventricular lining with intraventricular fluid-fluid levels, likely denoting pus. CSF sample was obtained for analysis and the diagnosis was confirmed.
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