38-year-old man with Dandy-Walker Syndrome and hydrocephalus. He has undergone multiple ventriculoperitoneal shunt revisions. Due to poor abdominal absorption, adhesions and infections, the decision was made to convert the ventriculoperitoneal shunt to a ventriculopleural shunt. We were asked to evaluate for shunt patency.
Dandy-Walker Syndrome* is a congenital brain malformation involving the cerebellum and ventricles. Presenting symptoms vary with age. This syndrome is association with other central nervous system disorders, including absent corpus callosum and other morphological malformations including heart, face, limbs, fingers and toes are also commonly described. Hydrocephalus is treated by shunting the CSF, most commonly into the peritoneal cavity. Alternatively, CSF can be diverted to the atrium or pleural space. The very first documented report of a ventriculopleural shunt was described in 1914 by Heile et al**, in the management of hydrocephalus. Currently, ventriculopleural diversions*** are commonly performed in cases of infected ventriculoperitoneal shunts. Small pleural effusions are commonly seen but usually are asymptomatic.