ASYMPTOMATIC SHUNT FRACTURE IN A PATIENT WITH HISTORY OF TUBERCULOUS MENINGOENCEPHALITIS: A CASE REPORT

Abstract

Ventriculoperitoneal (VP) shunt is the most frequently performed procedure in patients with hydrocephalus, but can cause seri¬ous complications. Shunt fractures, is a rare complication of VP shunt and can be damage for patient. The question of whether asymptomatic patients should or should not be operated on remains to be answered. The authors report a case of a pediatric patient who had an asymptomatic shunt fracture with a history of tuberculous menin¬goencephalitis (TBM). We report the case of a 7-year-old girl with a shunt fracture and a history of hydrocephalus due to TBM. She presented to the hospital in 2021 without symptoms of increased intracranial pressure and was fully conscious. Three weeks later, the patient experienced a gradual loss of consciousness. The result of the examination revealed that the hydrocephalus had become larger than before the operation in 2015. The peritoneal shunt had completely migrated into the peritoneal cavity. An emergency shunt revision was performed at the left Kocher point. After the operation, the patient regained consciousness and lived life without any complications. Although the decision to re-operate in an asymptomatic patient with a shunt fracture is debatable, shunt revision should be con¬sidered. Early revision of the shunt fracture does not pose a serious hazard to the patient.