PMC9767947_01
Cranial CT findings during the patient's six hospitalizations. No hydrocephalus was observed during the first hospitalization (A). Hydrocephalus was visible before the operation during the second hospitalization (B), and hydrocephalus was relieved post-operatively (C). Hydrocephalus was visible before the operation during the third hospitalization (D), and hydrocephalus was relieved post-operatively (E). Hydrocephalus was visible before the operation during the fourth hospitalization (F), and hydrocephalus was relieved post-operatively (G). Hydrocephalus was visible before the operation during the fifth hospitalization (H), and hydrocephalus was relieved post-operatively (I). Hydrocephalus was visible before the operation during the sixth hospitalization (J), and hydrocephalus was relieved post-operatively (K). Abdominal ultrasonography before surgery suggested an intra-abdominal encapsulated effusion (L).
fmed-09-1035201-g001.jpg
PMC9767947_01_fmed-09-1035201-g001.jpg
F1
CSF pressure exceeding 330 mmH2O, brain edema and hydrocephalus were not observed on cranial CT (Figure 1). CSF culture was negative. Head computed tomography (CT) suggested hydrocephalus (Figure 1), and the patient was subsequently admitted to the Department of Neurosurgery for ventriculoperitoneal shunt placement on 22 February 2019. Due to recurrent mechanical shunt obstruction, the patient underwent ventriculoperitoneal shunt tube explorations in the neurosurgery department on 09 January 2020; 26 March 2020; and 29 September 2020 (Figure 1). The patient underwent shunt tube exploration in the neurosurgery department again on 29 November 2020, due to hydrocephalus caused by mechanical shunt obstruction (Figure 1).
Timeline of the course of disease development.
fmed-09-1035201-g002.jpg
PMC9767947_01_fmed-09-1035201-g002.jpg
F2
Here, we present a detailed clinical timeline with the course of disease development (Figure 2).