Over-drainage secondary to ventriculosinus shunt: a case report

Abstract Background Shunting to the cranial venous sinus represents a novel treatment strategy for hydrocephalus. To our knowledge, overdrainage as a complication following shunting to the cranial venous sinus has not previously been reported in the clinical literature. Here we report the case of a 50-year-old man who suffered from overdrainage after a ventriculosinus shunt insertion. Case Description A 50-year-old man was admitted to our hospital with recurring fever and gait difficulty 4 months after a ventriculoperitoneal shunt (VPS) insertion for primary communicating hydrocephalus. Cerebrospinal fluid cultures were positive. The previous VPS was removed and, following successful antibiotic treatment evidenced by repeated negative cerebrospinal fluid (CSF) cultures, we performed a ventriculosinus shunt (VSS) operation. A postoperative computed tomographic (CT) scan of the head showed an excessively contracted ventricular system, subdural hemorrhage and effusion, indicating the occurrence of overdrainage. Conclusion Ventriculosinus shunt surgery is a feasible and reliable option for the treatment of hydrocephalus, especially for cases of failed ventriculoperitoneal shunt. However, there remains a risk of overdrainage occurring post-surgery, and this should be taken into consideration in clinical practice.