Case of the Week: June 7-June 14, 2012

20 month old with vomiting

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Case Details

The second shunt series done on 6/5/12 shows widening of coronal and sagittal sutures.

Answer

Diagnosis: Shunt Malfunction with Sutural Diastasis

The follow up CT showed increased size of the ventricles and patient underwent shunt revision. 

Complications of VP shunts:

Disconnection

Infection

Perforation

CSFoma

50% fail in first 2 years and 80% fail by 10 years.

Take Home Messages:

Comparison with baseline studies crucial.

Fluid tracking along shunt may be only sign of obstruction, even if normal or unchanged ventricles.

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