PMC5299149_01
Computed tomography scan showing Evans index of 0.62, confirming the diagnosis of normal pressure hydrocephalus
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F1
The diagnosis of NPH was confirmed by CT scan, with Evans index of 0.62, as shown in Figure 1.
Computed tomography scan after ventriculoperitoneal shunt with the catheter well positioned in the anterior horn of the right lateral ventricle
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F2
In our hospital, we routinely perform CT scans of the skull and abdomen as postoperative control, and both showed the entire system to be positioned properly [Figures 2 and 3].
Abdomen tomography after ventriculoperitoneal shunt with the catheter well positioned in the peritoneal cavity
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F3
In our hospital, we routinely perform CT scans of the skull and abdomen as postoperative control, and both showed the entire system to be positioned properly [Figures 2 and 3].
Abdomen tomography two days later, with the catheter lodged in the subcutaneous tissue, and cerebrospinal fluid collection in the same space
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F4
New abdomen CT identified the distal catheter protruding from the peritoneal cavity and housed beneath the subcutaneous tissue, producing a collection of CSF, as shown in Figure 4.
Aspect of coiling of the distal catheter after opening the abdominal incision
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F5
During further surgery to reposition the catheter, it was identified immediately below the skin after the incision, and no other pathological findings were noteworthy [Figures 5 and 6].
Distal catheter functioning wrapped in the subcutaneous space resulting in collection of cerebrospinal fluid
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F6
During further surgery to reposition the catheter, it was identified immediately below the skin after the incision, and no other pathological findings were noteworthy [Figures 5 and 6].
Abdomen tomography after repositioning of the distal catheter spread into the peritoneal cavity with no other complications
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F7
New control CT showed the catheter well positioned in the peritoneal cavity [Figure 7] and the patient symptoms improved.
Abdominal tomography 2 days after the second surgery demonstrating new protrusion of the catheter from the peritoneal cavity into the subcutaneous space
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F8
Another CT scan suggested the same event, with prolapsed and allocated catheter in abdominal subcutaneous and a collection of CSF, as illustrated in Figure 8.
Final control CT scan, with the ventricular catheter in the proper position
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F9
New surgical repositioning of the entire DVP system was performed uneventfully, with appropriate control scans [Figures 9 and 10].
Final control abdomen tomography, with the peritoneal catheter in proper position
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F10
New surgical repositioning of the entire DVP system was performed uneventfully, with appropriate control scans [Figures 9 and 10].