Proximalmigration of a lumboperitoneal shunt into the cerebello medullary cisterns

Abstract Background Lumboperitoneal (LP) shunt is a type of treatment commonly used in the surgical treatment of pseudotumor cerebri, comorbid hydrocephalus, cerebrospinal fluid (CSF) fistula. Despite the promising results of the LP shunt blockage of %7 and %14 migration rate of complications have been reported. Migration can be rarely observed in the spinal subarachnoid space or even in the intracranial area. We report a case where the LP shunt migrated upward to the cerebellomedullary cisterns. Case Description A 37-year-old female patient underwent lumboperitonel shunt surgery for pseudotumor cerebri. After the LP shunt surgery, the patient's complaints of headache and blurred vision disappeared. The patient admitted to polycyclic at the postoperative first month with neck pain and neck sucking sensation. Cerebellomedullar cysterna shunt tip was seen in brain CT. The patient was operated again and the proximal end of the shunt was lowered to Lumbar 1 level under C-Arm Scope device control. Then, we fixed the subcutaneous tissue of the shunt of the LP shunt with the help of a non-resorbable suture and stitches. Conclusions LP shunt distal migration is more common, such proximal migrations are rarely reported in the literature. LP shunt displacement must be due to defective or insufficient anchoring devices of the LP shunt tube. We think that great care must be taken to fix the LP shunt properly with the help of suture collars with an unresorbable suture at three places to the subcutaneous tissue.