Isolated Unilateral Hydrocephalus Following Ventriculoatrial Shunt

SHIFT of the brain stem may cause sudden death following decompression of one lateral ventricle by a ventriculoatrial shunt if there is a lack of communication between the two lateral ventricles. Isolated loculations of a ventricle following ventriculitis may have a similar effect. This is essentially an acute form of unilateral hydrocephalus. Post-surgical instances of this type of isolated hydrocephalus are apparently quite unusual. In DeLange's monograph 3 on hydrocephalus, no mention is made of this syndrome. However, in his list of autopsy cases, there were two patients who had an occlusion of the foramen of Monro. One patient had died 8 months after the insertion of the shunt and the second, 17 days after the insertion of the shunt. The clinical course is not given. Emery ~ performed autopsies on 44 patients with shunts all of whom had myelomeningocele and hydrocephalus. Unilateral hydrocephalus was not demonstrated in any of these patients. Numerous articles have been written on complications associated with ventriculoatrial shunting of the cerebrospinal fluid, 6 but none refer to postshunt isolated hydrocephalus. The fact that we have seen five such patients recently suggests that this condition may be unrecognized rather than rare.