Episodic ventriculomegaly due to hypernatremia mimicking shunt malfunction: case report

Sarah Jernigan, Scellig S D Stone, Joshua P. Aronson, Melissa Putman, Mark R. Proctor

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Patients with shunted hydrocephalus presenting with altered mental status and ventriculomegaly are generally considered to be in shunt failure requiring surgical treatment. The authors describe a case of shunted hydrocephalus secondary to a disseminated neuroectodermal tumor in a pediatric patient in whom rapid fluctuations in sodium levels due to diabetes insipidus repeatedly led to significant changes in ventricle size, with invasively confirmed normal shunt function and low intracranial pressure. This clinical picture exactly mimics shunt malfunction, requires urgent nonsurgical therapy, and underscores the importance of considering serum osmolar abnormalities in the differential diagnosis for ventriculomegaly.

Original languageEnglish (US)
Pages (from-to)406-409
Number of pages4
JournalJournal of Neurosurgery: Pediatrics
Volume16
Issue number4
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Keywords

  • DDAVP = desmopressin acetate
  • FOR = frontal and occipital horn ratio
  • hydrocephalus
  • hypernatremia
  • ICP = intracranial pressure
  • shunt
  • ventriculomegaly

ASJC Scopus subject areas

  • Medicine(all)

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