Total intracranial migration of ventriculoperitoneal shunt

Background. The ventriculoperitoneal shunt is a common treatment for hydrocephalus. There are several complications associated with it. Shunt failure is one of the most frequent complications, but total intracranial shunt migration is quite uncommon. The exact cause of shunt migration is unknown, but several factors are thought to play a role. Case presentation. A 10-month-old boy was diagnosed with total intracranial migration of a ventriculoperitoneal shunt (Chhabra type). We used neuroendoscopy to remove this intracranially migrated shunt and implanted a new ventriculoperitoneal shunt (Medtronic type) on the opposite side. He had a favourable clinical outcome. Conclusion. Total intracranial shunt migration is an uncommon complication which is most likely caused by increased intraperitoneal pressure, strong head movements, and insufficient shunt fixation. Better patient handling combined with appropriate operative technique would be the best way to prevent shunt migration.