Abstract
The formation of a brain abscess as a result of a cerebrospinal fluid shunt complication is extremely rare in the literature with only 7 cases reported in the last 20 years. We report a patient that developed a brain abscess adjacent to a functioning ventricular catheter in the presence of shunt infection by another pathogen. Clinicians should consider this complication in any shunted patient with clinical features of infection and suggestive changes on imaging however subtle. Expedited standard management for the abscess and the CSF shunt infection, if present, should be employed. Removal of all non-functioning catheters should be encouraged.
Highlights
The insertion of a cerebrospinal fluid (CSF) shunt remains the most common operation for the treatment of hydrocephalus
The formation of a brain abscess as a result of a shunt complication is extremely rare in the literature with only 7 cases reported in the last 20 years and another 4 cases reported earlier to that. [4,5,6,7,8,9,10] In this article we report a patient that developed a brain abscess adjacent to a functioning ventricular catheter in the presence of CSF shunt infection by another pathogen
It is hoped that presentation of the case will draw clinicians' attentions to this rare and important shunt complication and allow us to make some observations about the clinical characteristics of brain abscess in shunted patients in general
Summary
The insertion of a cerebrospinal fluid (CSF) shunt remains the most common operation for the treatment of hydrocephalus. [4,5,6,7,8,9,10] In this article we report a patient that developed a brain abscess adjacent to a functioning ventricular catheter in the presence of CSF shunt infection by another pathogen. A 9-month-old male child with congenital hydrocephalus was admitted to our neurosurgical unit and underwent the insertion of a right parietal ventriculo-peritoneal (VP) shunt He was known to have multiple congenital anomalies that had been detected from birth. BlcFoariwugasiu-nidnreCegnTs1slit(gyPhltariinne)da:esanhdtojawtcieoinnngtidtnoiltahttheedovvceecnnipttrirtiiacclulehlasorarcnadthreigthetr paanrdietal Brain CT (Plain): showing dilated ventricles and right parietal low-density area adjacent to the ventricular catheter and causing slight indentation in the occipital horn. Contrast MRI (Figure 2) showed a small right parietal ring-enhancing lesion adjacent to the ventricular catheter with surrounding edema causing mild mass effect. The patient made a good recovery and a follow up CT scan four weeks later confirmed complete resolution of the brain abscess
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