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Vol. 15. Issue 5.
Pages 472-475 (January 2004)
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Vol. 15. Issue 5.
Pages 472-475 (January 2004)
Absceso cerebral tardío como complicación de una derivación ventrículo-peritoneal
Delayed brain abscess as a complication of a CSF shunt
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I. Arrese
, A.P. Núñez, J.J. Rivas, R.D. Lobato
Servicio de Neurocirugía. Hospital 12 de Octubre. Madrid
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Resumen
Introducción

La infección es una complicación habitual de las válvulas de derivación ventriculoperitoneal, pero la formación de un absceso cerebral es una complicación muy rara. Presentamos el caso de una paciente que desarrolló absceso cerebral alrededor del catéter ventricular de una válvula que había sido retirada por infección un año antes.

Caso clínico

Mujer de 38 años, sometida a derivación ventriculoperitoneal por hidrocefalia secundaria a neurinoma del acústico, que a lo largo de un periodo de trece años desarrolló dos episodios de meningitis, por lo que se procedió a la retirada del sistema, dejando el catéter ventricular que parecía estar adherido al plexo coroideo. Un año más tarde la paciente desarrolló un absceso cerebral alrededor del catéter. Se procedió a evacuar el absceso y a extraer el catéter. El germen cultivado fue un Proteus mirabilis.

Discusión

El riesgo inherente a la retirada de un catéter ventricular adherido al plexo coroideo debe contrapesarse con el riesgo de infección secundario a la permanencia del mismo.

Palabras clave:
Derivación ventriculoperitoneal
Infección
Absceso cerebral
Sumary
Introduction

Infection is a common complication of ventriculoperitoneal shunts, but the formation of a brain abscess related to shunt system is very rare. We present the case of a patient who developed a brain abcess around a ventricular catheter left in place after removing the valvular system.

Case report

This 38 years old woman, underwent ventriculoperitoneal shunting for hydrocephalus secon-dary to an acoustic neurinoma. During a period of thirteen years she suffered two episodes of meningitis, and after the second one the CSF shunt was removed excepting for the ventricular catheter which appeared to be adherent to the choroid plexus. One year later, a brain abscess arised around that catheter, and both the abscess and the catheter were removed (Proteus mirabilis was the cultured germ).

Discussion

In spite of the risks related to removal of a proximal catheter adherent to the choroid plexus, the risk linked to the removal of a ventricular catheter must be counterbalanced with the risk of infection.

Key words:
Cerebrospinal fluid shunt
Infection
Brain abcess

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