Shunt migration into the sphenoid sinus: Case report

Khan W. Li, Elisa Ciceri, Giovanni Lasio, Carlo L. Solero, Francesco DiMeco, J. Gordon McComb, Robin P. Humphreys, Marc P. Sindou

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)441-443
Number of pages3
JournalNeurosurgery
Volume53
Issue number2
StatePublished - Aug 1 2003
Externally publishedYes

Keywords

  • Arachnoid cyst
  • Cerebrospinal fluid leak
  • Complication
  • Migration
  • Proximal
  • Shunt

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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  • Cite this

    Li, K. W., Ciceri, E., Lasio, G., Solero, C. L., DiMeco, F., McComb, J. G., Humphreys, R. P., & Sindou, M. P. (2003). Shunt migration into the sphenoid sinus: Case report. Neurosurgery, 53(2), 441-443.