Document Detail


Shunt migration into the sphenoid sinus: case report.
MedLine Citation:
PMID:  12925265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE AND IMPORTANCE: Shunt catheter migration is a potential complication of cerebrospinal fluid shunting procedures. We report an unusual case of proximal shunt migration into the sphenoid sinus. To our knowledge, there have been no previous reports of shunt migration through the bony structures of the cranial base. CLINICAL PRESENTATION: A 41-year-old man who had had a cyst-to-peritoneum shunt placed 21 years earlier for a temporal lobe arachnoid cyst presented with cerebrospinal fluid rhinorrhea. Neuroradiological imaging revealed migration of the shunt catheter through the medial wall of the middle temporal fossa into the sphenoid sinus. INTERVENTION: The patient underwent shunt removal and repair of the dural defect. Intraoperatively, the proximal catheter tip was found in the sphenoid sinus with dural and bony erosion. The patient made an uneventful recovery. CONCLUSION: We present a unique long-term complication associated with intracranial shunt catheters. We hypothesize that excessive proximal catheter length and chronic cerebrospinal fluid pulsations contributed to migration of the catheter into the sphenoid sinus.
Authors:
Khan W Li; Elisa Ciceri; Giovanni Lasio; Carlo L Solero; Francesco DiMeco
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  53     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-19     Completed Date:  2003-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-3; discussion 443     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebrospinal Fluid Rhinorrhea / diagnosis*,  etiology*,  surgery
Cerebrospinal Fluid Shunts / adverse effects*
Cranial Fossa, Middle / pathology*,  radiography*,  surgery
Device Removal*
Foreign-Body Migration / diagnosis*,  etiology*,  surgery
Humans
Magnetic Resonance Imaging
Male
Sphenoid Sinus / pathology*,  radiography*,  surgery
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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