Migration and coiling of peritoneal catheter into the subgaleal space: a very rare complication of subgaleoperitoneal shunt

Abstract

Upward migration of the peritoneal catheter of a subgaleo-peritoneal (SP) shunt and coiling into the subgaleal space is an extremely rare complication of a SP shunt. A 32-year-old male patient visited our hospital presenting with a large skull defect due to a prior craniectomy performed elsewhere. The patient underwent a cranioplasty with methylmetacrylate, but subsequently developed progressive pseudomeningocele and subgaleal cerebrospinal fluid (CSF) collection. The patient underwent CSF diversion via a SP shunt. After SP shunting, the pseudomeningocele disappeared completely. Six months later, the patient presented with progressive scalp swelling. Skull X-ray showed migration and coiling of the distal catheter of the SP shunt. The patient was treated by removing the entire shunt catheter and the dura was covered with a subgaleal flap. We would like to report our experience with a very rare complication of subgaleo-peritoneal shunting.

Keywords: Migration; Pseudomeningocele; Subgaleo-peritoneal shunt.

Fig. 1

Brain computed tomography reveals the big right subgaleal fluid collection, pseudomeningocele.

Fig. 2

Skull (A) and abdominal (B) X-ray show the well placed proximal and peritoneal catheter.

Fig. 3

Lateral view of skull X-ray shows coiling of whole shunt catheter.

Fig. 4

Brain computed tomography demonstrates that pseudomeningocele is disappeared.