Ventriculoperitoneal shunt malfunction from cerebrospinal fluid eosinophilia in children: case-based update

Introduction Malfunction of cerebrospinal shunts is common and is due to multiple etiologies ranging from obstruction due to infiltrated brain tissue to mechanical disconnection. Discussion We review the differential diagnosis and recommended evaluation and treatment for cerebrospinal fluid (CSF) eo...

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Bibliographic Details
Published in:Child's nervous system 2012-03, Vol.28 (3), p.345-348
Main Authors: Tubbs, R. Shane, Muhleman, Mitchel, Loukas, Marios, Cohen-Gadol, Aaron A.
Format: Article
Language:English
Subjects:
Case-Based Update
Child
Diagnosis, Differential
Eosinophilia - cerebrospinal fluid
Eosinophilia - diagnosis
Eosinophilia - etiology
Eosinophilia - therapy
Headache - surgery
Humans
Male
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Ventriculoperitoneal Shunt - adverse effects
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Summary:Introduction Malfunction of cerebrospinal shunts is common and is due to multiple etiologies ranging from obstruction due to infiltrated brain tissue to mechanical disconnection. Discussion We review the differential diagnosis and recommended evaluation and treatment for cerebrospinal fluid (CSF) eosinophilia. Illustrative case We report a child who, following the use of an antibiotics-impregnated ventricular catheter, developed sterile ventriculoperitoneal shunt malfunction thought to be due to profound CSF eosinophilia. Following removal of the catheter, the eosinophilia spontaneously resolved, and at long-term follow up, the patient has a functioning non-antibiotic impregnated shunt catheter. Conclusions Patients presenting with signs of shunt malfunction but without signs of CSF infection and with a raised CSF eosinophilia should be suspicious for cellular obstruction of their shunt system, i.e., sterile shunt malfunction.
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-011-1530-x