Complete intracranial migration of ventriculoperitoneal shunt – a case report

Abstract

Introduction: Hydrocephalus is commonly managed with ventriculoperitoneal shunt (VPS) placement. While effective, it carries risks such as malfunction, infection, and migration. Complete intracranial migration is a rare complication occurring in 0.1%–0.4% of cases. Case Presentation: A 5-month-old female infant presented with lethargy and vomiting three months after left Keen’s point VPS insertion. Imaging confirmed complete intracranial migration of the entire shunt apparatus into the ventricles. The shunt was retrieved endoscopically, followed by insertion of a new VPS contralaterally. Discussion: Proximal shunt migration is linked to factors such as wide burr holes, large dural openings, and insecure fixation. Endoscopic removal is standard, with new shunt placement if no infection is present. Preventive measures should be prioritized, and long-term monitoring is essential for detecting complications. Conclusion: Complete intracranial VPS migration is an uncommon complication that necessitates prompt intervention. Our experience underscores that adherence to strict surgical principles can substantially prevent its occurrence.