[Distal ventriculoperitoneal shunt catheter migration into the pulmonary artery: a rare complication]

Ventriculoperitoneal shunt placement is a common treatment for hydrocephalus, although not devoid of complications. We report a case of a 60-year-old male who underwent ventriculoperitoneal shunt implantation for the treatment of post-traumatic hydrocephalus. Thirteen months post- surgery, after an initial clinical improvement, the patient manifested gait and cognitive disorders. Chest X-rays and computed tomography revealed that the distal shunt catheter had migrated into the pulmonary artery. The catheter was removed by reopening the previous retroauricular incision followed by manual traction, without incidents. A new peritoneal catheter was implanted with immediate clinical improvement and no further complications two years after the second surgery. We communicate a rare complication of a standard neurosurgical procedure that can be detected by different healthcare professionals, and review its various forms of presentation and multidisciplinary management strategies from 19 similar clinical cases found in the literature.

[Actinomycotic brain abscess in immunocompetent patient]

BACKGROUND

The actinomyces is germ commonly found in the normal flora of the oral cavity and gastro-intestinal and uro-genital tracts. Involvement in other locations is a very uncommon event.

OBJECTIVES

To describe a patient with an actinomicotyc brain abscess CLINICAL CASE: We report the case of a patient who suffered a seizure and decreased level of consciousness. Imaging tests revealed the presence of lesions both in the lung and in the brain. An urgent craniotomy was performed and the diagnosis of actinomicotyc abscess was obtained.

CONCLUSION

We describe the differential characteristics of this type of infection, discussing the diagnostic process and management in detail.