Shunt Valve Rupture: An Interesting Case Report of Ventriculoperitoneal Shunt Failure

GÜDÜK, Mustafa; AKBAŞ, Ahmet; TÜZÜNALP, Mürüvvet Ayten; BERİKOL, Gürkan; Şakir EKŞİ, Murat

Background Shunt complications are common despite advances in surgical techniques and shunting technology. Proximal and/or distal catheter malfunctions are detected in pediatric and adult patients. However, valve dysfunction is rare in those cases. Case description We presented a 24-year-old woman with a history of ventriculostomy and ventriculoperitoneal shunt (VPS) due to hydrocephalus concomitant with Dandy-Walker Syndrome. She has had undulant headache and vision loss episodes in both eyes for fifteen days. Her VPS valve was normal when manually checked and her VPS was observed as intact on X-ray and computerized tomography (CT) scan. She had high-grade papilledema in both eyes with an optical coherence eye tomography (OCT) scan value of 55/99. Lumbar puncture (LP) was performed. Her cerebrospinal fluid (CSF) opening pressure was 560 mm H2O under sedation. We did a VPS exploration procedure. There was a tiny defect over the shunt valve from where clear CSF was leaking. We revised the old VPS valve with a new one of 1.5 regular pressure. Her vision improved shortly after the surgery. Conclusion The presented case is a very rare example of shunt valve dysfunction that required further investigation and a new valve replacement even though her pre-operative imaging was normal.