Pseudocyst in Neck: A Case Report on Rare Complication of Ventriculoperitoneal Shunt

Abstract

Introduction: Ventriculoperitoneal shunt is a common neurosurgical procedure, for the definitive management of hydrocephalus. Shunt failures may occur due to various causes but are usually due to infections in adults and catheter occlusion in the paediatric population. Case Report. The 13-year-old girl presented with a right lateral neck swelling. In detailed history, she was found to be an old case of ventriculoperitoneal shunt. The clinical examination and radiological investigation revealed proximal dislodgment of the stent from the cranium, causing persistent cerebrospinal fluid (CSF) leak and pseudocyst formation in the neck.

Conclusion: The case highlights CSF pseudocyst formation as a rare differential for lateral neck swellings.

Figure 1

(a, b) Anterior and lateral clinical picture, showing tortuous swelling overlying right sternocleidomastoid.

Figure 2

Positive transillumination test of the patient with the shadow of shunt in situ.

Figure 3

The 3-dimensional reconstructed image of CT scan showing VP shunt proximal end lying extracranially.

Figure 4

Computed tomography of the brain, axial section showing dilated ventricles suggestive of hydrocephalus.

Figure 5

(a, b) Noncontrast computed tomogram of neck, coronal and axial sections showing the CSF pseudocyst involving the sternocleidomastoid on the right side with VP shunt in situ (white arrow).