Delayed Cerebral Abscess as a Shunt Complication and Endoscopic Removal of the Ventricular Catheter and Abscess

  • Shin, Dong-Seong (Department of Neurosurgery Soonchunyang University Bucheon Hospital) ;
  • Hwang, Sun-Chul (Department of Neurosurgery Soonchunyang University Bucheon Hospital) ;
  • Kim, Bum-Tae (Department of Neurosurgery Soonchunyang University Bucheon Hospital) ;
  • Shin, Won-Han (Department of Neurosurgery Soonchunyang University Bucheon Hospital)
  • Published : 2008.06.13

Abstract

Shunt infections are a common complication of ventriculoperitoneal (VP) shunts, but the formation of a brain abscess related to a shunt system is very rare. A 44-year-old woman had a VP shunt inserted for hydrocephalus secondary to a subarachnoid hemorrhage. She suffered an episode of meningitis and sepsis 8 months after the shunt operation. After recovering from the meningitis, she complained of a loss of cognitive function. An enhancing mass was found in the frontal lobe, around the frontal horn of the lateral ventricle, and the ventricular catheter was embedded inside the mass. The ventricular catheter and cerebral abscess were removed using neuroendoscopy. We present an interesting case of a shunt-related brain abscess which illustrates the usefulness of neuroendoscopy.

Keywords

References

  1. Arrese I, Nunez AP, Rivas JJ, Lobato RD : [Delayed brain abscess as a complication of a CSF shunt.] Neurocirugia (Astur) 15 : 472- 475, 2004 https://doi.org/10.1016/S1130-1473(04)70461-3
  2. Barazi SA, Gnanalingham KK, Chopra I, van Dellen JR : Delayed postoperative intracerebral abscess caused by Propionibacterium acnes: case report and review of the literature. Br J Neurosurg 17 : 336-339, 2003 https://doi.org/10.1080/02688690310001601225
  3. Brownlee RD, Dold ON, Myles ST : Intraventricular hemorrhage complicating ventricular catheter revision: incidence and effect on shunt survival. Pediatr Neurosurg 22 : 315-320, 1995 https://doi.org/10.1159/000120922
  4. Chehrazi B, Duncan CC : Removal of retained ventricular shunt catheters without craniotomy. Technical note. J Neurosurg 56 : 160-161, 1982 https://doi.org/10.3171/jns.1982.56.1.0160
  5. Choksey MS, Malik IA : Zero tolerance to shunt infections : can it be achieved? J Neurol Neurosurg Psychiatry 75 : 87-91, 2004
  6. Gower DJ, Horton D, Pollay M : Shunt-related brain abscess and ascending shunt infection. J Child Neurol 5 : 318-320, 1990 https://doi.org/10.1177/088307389000500409
  7. Gupta R, Mohindra S, Dhingra AK : Are non-functioning intraventricular shunt catheters really dormant? Br J Neurosurg 21 : 297-298, 2007 https://doi.org/10.1080/02688690701317151
  8. Jo SD, Kim E, Lee CY, Kim IS, Son EI, Kim DW, et al : Clinical features and surgical treatment of bacterial brain abscess. J Korean Neurosurg Soc 41 : 391-396, 2007
  9. Lee JH, Kim DS, Choi JU : Complications after the ventriculoperitoneal shunt according to the time course. J Korean Neurosurg Soc 25 : 1851-1855, 1996
  10. Pandey P, Suri A, Singh AK, Mahapatra AK : Brain abscess-an unusual complication of ventriculo-peritoneal shunt. Indian J Pediatr 70 : 833-834, 2003 https://doi.org/10.1007/BF02723809
  11. Park IS, Lee CM, Kim YT, Ha HG : Post-shunt infection in hydrocephalus. J Korean Neurosurg Soc 27 : 476-480, 1998
  12. Sagan LM, Kojder I, Madany L : [Endoscopic revision of adherent ventricular catheter. Evaluation of the method]. Neurol Neurochir Pol 39 : 294-299, 2005
  13. Sarguna P, Lakshmi V : Ventriculoperitoneal shunt infections. Indian J Med Microbiol 24 : 52-54, 2006 https://doi.org/10.4103/0255-0857.19896
  14. Vougioukas VI, Feuerhake F, Hubbe U, Reinacher P, Van Velthoven V : Latent abscess formation adjacent to a nonfunctioning intraventricular catheter. Childs Nerv Syst 19 : 119-121, 2003
  15. Wang KW, Chang WN, Shih TY, Huang CR, Tsai NW, Chang CS, et al : Infection of cerebrospinal fluid shunts: causative pathogens, clinical features, and outcomes. Jpn J Infect Dis 57 : 44-48, 2004