Intraparenchymal pericatheter cyst after cerebrospinal fluid shunt: A rare complication with challenging diagnosis – Case presentation and review of the literature

Ploutarchos Karydakis; Ioannis Nikas; Dimitrios Panagopoulos; Maria Filippidou; George Sfakianos; Marios Themistocleous

doi:10.4103/ajns.AJNS_288_18

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 581-584
DOI: 10.4103/ajns.AJNS_288_18

Case Report

Intraparenchymal pericatheter cyst after cerebrospinal fluid shunt: A rare complication with challenging diagnosis – Case presentation and review of the literature

Ploutarchos Karydakis

Department of Neurosurgery, 251 Hellenic Air Force General Hospital, Athens

,

Ioannis Nikas

¹Department of Medical Imaging and Interventional Radiology, Agia Sofia Children's Hospital, Athens

,

Dimitrios Panagopoulos

²Department of Neurosurgery, Children Hospital “Aghia Sophia”, Athens

,

Maria Filippidou

³First Department of Pediatrics, University of Athens, “Agia Sofia” Children's Hospital, Athens

,

George Sfakianos

²Department of Neurosurgery, Children Hospital “Aghia Sophia”, Athens

,

Marios Themistocleous

²Department of Neurosurgery, Children Hospital “Aghia Sophia”, Athens

› Author Affiliations

Abstract

An intraparenchymal pericatheter cyst is a rare complication of ventriculoperitoneal shunt, which is not well described yet. Due to its rarity, lack of characteristic symptoms and radiological features that often mimic brain tumors or abscesses, especially in head computed tomography without contrast can be easily misdiagnosed. We report the case of a 9-year-old girl who was admitted to a peripheral hospital due to severe headaches and vomiting. The child had a history of craniotomy and ventriculoperitoneal shunt for posterior fossa tumor, performed in our department, 4 years earlier. The patient underwent a brain magnetic resonance imaging (MRI) scan and transmitted to our hospital with the diagnosis of brain tumor. However, a closer look at the MRI established the diagnosis of intraparenchymal pericatheter cerebrospinal fluid cyst; hence, the patient underwent shunt revision and cyst drainage. We researched the literature and described 20 reported cases, discussing the pathophysiological mechanisms, the radiological features, and the optimal treatment of this interesting, yet a challenging complication.

Key-words:

Cerebrospinal fluid - intraparenchymal pericatheter cyst - shunt revision - ventriculoperitoneal shunt

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References

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