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Nagahama Y, Peters D, Kumonda S, et al. Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient. Epilepsy Behav Case Rep. 2017;7:34-36doi: 10.1016/j.ebcr.2016.12.003.
Nagahama, Y., Peters, D., Kumonda, S., Vesole, A., Joshi, C., J Dlouhy, B., & Kawasaki, H. (2017). Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient. Epilepsy & behavior case reports, 734-36. https://doi.org/10.1016/j.ebcr.2016.12.003
Nagahama, Yasunori, et al. "Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient." Epilepsy & behavior case reports vol. 7 (2017): 34-36. doi: https://doi.org/10.1016/j.ebcr.2016.12.003
Nagahama Y, Peters D, Kumonda S, Vesole A, Joshi C, J Dlouhy B, Kawasaki H. Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient. Epilepsy Behav Case Rep. 2017 Jan 24;7:34-36. doi: 10.1016/j.ebcr.2016.12.003. eCollection 2017. PMID: 28348960; PMCID: PMC5357741.
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Epilepsy Behav Case Rep. 2017 Jan 24;7:34-36. doi: 10.1016/j.ebcr.2016.12.003. eCollection 2017.

Delayed diagnosis of shunt overdrainage following functional hemispherotomy and ventriculoperitoneal shunt placement in a hemimegalencephaly patient.

Epilepsy & behavior case reports

Yasunori Nagahama, David Peters, Sho Kumonda, Adam Vesole, Charuta Joshi, Brian J Dlouhy, Hiroto Kawasaki

Affiliations

  1. Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  2. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  3. Surgery residency program, Teine Keijinkai Hospital, Sapporo, Japan.
  4. Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

PMID: 28348960 PMCID: PMC5357741 DOI: 10.1016/j.ebcr.2016.12.003

Abstract

Shunt overdrainage represents a nebulous condition of variable clinical and imaging presentations, where the diagnosis is primarily clinical. The condition presents a diagnostic challenge particularly in patients with cognitive impairment and developmental delays. Here we present a 3-year-old boy with drug-resistant focal onset seizures due to hemimegalencephaly who previously underwent functional hemispherotomy followed by ventriculoperitoneal shunt placement for postoperative hydrocephalus. The subsequent clinical course was complicated by delayed diagnosis of shunt overdrainage in the absence of significant image findings. Maintaining a high index of suspicion for the possibility of shunt overdrainage is critical even in the face of unremarkable imaging findings.

Keywords: Hemimegalencephaly; Hemispherectomy; Peri-insular functional hemispherotomy; Postoperative hydrocephalus; Shunt overdrainage

References

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