Cerebrospinal fluid (CSF) diversion procedure has been used for long to treat hydrocephalus in children. The principle of shunting is to establish a communication between the CSF and a drainage cavity (peritoneum, right atrium, and pleura). Ventriculoperitoneal shunt is used most commonly, followed secondly by ventriculopleural shunt (VPLS). Hydrothorax due to excessive CSF accumulation is a rare complication following both the type of shunts and is more frequently seen with VPLS. We report a case of a 6-year-old female child presenting with massive CSF hydrothorax with respiratory failure following VPLS. The aim of the article is to highlight early recognition of this rare and life-threatening condition, which could easily be missed if proper history is not available.
Beach C, Manthey DE. Tension hydrothorax due to ventriculopleural shunting. J Emerg Med 1998;16:33-6.
Irani F, Elkambergy H, Okoli K, Abou DS. Recurrent symptomatic pleural effusion due to a ventriculopleural shunt. Respir Care 2009;54:1112-4.
Grunberg J, Rébori A, Verocay MC, Ramela V, Alberti R, Cordoba A. Hydrothorax due to ventriculopleural shunting in a child with spina bifida on chronic dialysis: Third ventriculostomy as an alternative of cerebrospinal diversion. Int Urol Nephrol 2005;37:571-4.
Weprin B, Swift D. Complications of ventricular shunts. Tech Neurosurg 2002;7:224-42.
Paldino M, Mogilner AY, Tenner MS. Intracranial hypotension syndrome: A comprehensive review. Neurosurg Focus 2003;15:ECP2.
Park ES, Kim E. Spontaneous intracranial hypotension: Clinical presentation, imaging features and treatment. J Korean Neurosurg Soc 2009;45:1-4.