Journal of Yeungnam Medical Science

Case report

Shunt fracture as a sequela of cervical spine manipulation: a case report: El Kim; J Yeungnam Med Sci. 2023;40(Suppl):S109-S112. Published online July 17, 2023; DOI: https://doi.org/10.12701/jyms.2023.00479

Abstract PDF: Shunt disconnection is an unreported complication of spinal mobilization and manipulation. We present the case of a young adult who underwent cystoperitoneal (CP) shunt placement for an arachnoid cyst at the age of 6 years. The shunt remained functional during a follow-up period of 11 years. The patient was admitted with headache and diplopia that started after cervical manipulation by a chiropractor. Radiography revealed fracture of the distal catheter and resultant enlargement of the temporosylvian cyst. The patient required replacement of the disconnected tubing caudal to the shunt valve. The distal catheter ruptured immediately below the outlet connector of the valve. The symptoms and signs resolved completely after insertion of a new distal tube into the peritoneum. This case report demonstrates that chiropractic manipulation of the neck may be a cause of tubing breakage in patients with CP shunts.

Case Report

Cystoperitoneal Shunting after Fenestration of an Enlarging Arachnoid Cyst.: Ik Chan Jeon, Min Su Kim, Seong Ho Kim, Sung Ho Jang; Yeungnam Univ J Med. 2008;25(2):160-164. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.160

Abstract PDF: A two-month-old girl with a history of an incidental arachnoid cyst in the prenatal period (38 weeks) presented with persistent irritability. A follow-up computed tomographic (CT) scan revealed an enlarged arachnoid cyst with hydrocephalus. We performed craniotomy and fenestration, but the cyst size did not decrease, and hydrocephalus had worsened on a follow-up CT scan performed 13 months after fenestration. The patient was treated with cystoperitoneal shunting. Follow-up magnetic resonance imaging (MRI) performed 5 years later revealed that the arachnoid cyst had decreased in size and that the hydrocephalus had resolved. Enlarging arachnoid cysts are not common, and optimal surgical treatment is uncertain. Based on the features of this case, we believe cystoperitoneal shunting is an advisable surgical intervention for patients with enlarging arachnoid cysts presenting with hydrocephalus.

Search