Isolated hypoglossal nerve palsy due to metastatic germinoma in the neck: a ventriculoatrial shunt-related complication

A 12-year-old boy with suprasellar germinoma was treated with a right-sided ventriculoatrial shunt at diagnosis. He subsequently developed a metastatic neck mass that presented with an isolated right hypoglossal nerve palsy. Radiological investigations showed a vascular tumor and thrombosis of the right internal jugular vein. It is hypothesized that thrombosis at the venous inflow channel allowed local proliferation of the tumor cells that exited from the intracranial cavity via the shunt.