ABSTRACT
BACKGROUND: Ventriculopleural (VPL) shunts are used infrequently in management of hydrocephalus. The main complication associated with these shunts is pleural effusion. CASE DESCRIPTION: A 28-year-old man with a history of congenital hydrocephalus had a VPL shunt inserted. Two years later, he noticed a soft bulging in the surgical scar area of the chest, suggestive of fluid accumulation. The scar subsequently opened up spontaneously exposing the distal catheter, which extruded through the opening. Chest radiographs and computed tomography scan showed an important pleural effusion on the same side. The VPL shunt was removed, and a contralateral shunt was inserted. CONCLUSIONS: To our knowledge, spontaneous extrusion of the distal catheter of a VPL shunt has not been previously reported in the literature. Physicians treating patients with hydrocephalus must be aware of this potential complication when a VPL shunt is inserted.
Subject(s)
Cerebrospinal Fluid Shunts/adverse effects , Hydrocephalus/surgery , Pleural Effusion/etiology , Postoperative Complications/etiology , Prosthesis Failure/adverse effects , Adult , Humans , Hydrocephalus/congenital , Male , Pleura , Pleural Effusion/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Tomography, X-Ray ComputedABSTRACT
Microsurgery for brain aneurysms is a current relevant technique, as advances in endovascular and stent-assisted coiling have not solved many of the difficulties inherent in the management of complex brain aneurysms. The following review highlights the importance of microsurgical bypass techniques for the management of complex cerebrovascular aneurysms and emphasizes, through two clinical cases, the technical difficulties and indications for bypass surgery. These cases demonstrate that in selected scenarios, bypass microsurgery still offers the only viable treatment for complex aneurysms.
