Case report demonstrates effective endoscopic management of malpositioned shunt in obstructive hydrocephalus, implying less invasive solutions are viable.
Background Hydrocephalus is one of the most common brain disorders in pediatric patients. It is a highly complex condition and a leading cause of neurological sequelae, primally resulting from prematurity, intraventricular hemorrhage, or infections. Case presentation We present the case of a 5-month-old male with a medical history of emergency cesarean delivery at 31.5 weeks due to preeclampsia, who developed grade IV intraventricular hemorrhage with secondary obstructive hydrocephalus and multicystic encephalomalacia. Initial management with a ventriculoperitoneal shunt was complicated by malposition of the proximal ventricular catheter. The patient subsequently underwent a neuroendoscopic procedure, which included third ventriculostomy, septal fenestration. We also performed an endoscopic repositioning of the proximal catheter. Conclusions This endoscopic maneuver successfully avoided a more invasive procedure for removal and complete replacement of a new shunt system.
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Ardila et al. (2026) studied this question.
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