Bilateral Proptosis in a Child-A Rare Manifestation of Ventriculoperitoneal Shunt Obstruction

Deepti Verma; David Chyi Yeu Low; Joel Kian Boon Lim

doi:10.1055/s-0040-1713677

Bilateral Proptosis in a Child-A Rare Manifestation of Ventriculoperitoneal Shunt Obstruction

J Pediatr Intensive Care. 2020 Jul 29;10(4):311-316. doi: 10.1055/s-0040-1713677. eCollection 2021 Nov.

Authors

Deepti Verma¹, David Chyi Yeu Low², Joel Kian Boon Lim³

Affiliations

¹ Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore.
² Neurosurgical Service, Division of Surgery, KK Women's and Children's Hospital, Singapore, Singapore.
³ Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore.

Abstract

Ventriculoperitoneal shunt (VPS) obstruction may have a myriad of presentations. We reported a case of an 11-year-old girl presenting with acute, bilateral proptosis secondary to VPS obstruction. While neuroimaging was interpreted as unremarkable, fundoscopy revealed bilateral papilledema and lumbar puncture showed elevated intracranial pressure. Neurosurgical exploration demonstrated VPS valve obstruction and a new VPS was inserted. Postoperatively, she developed a recurrent extradural hematoma, which was initially evacuated and later managed conservatively. To our knowledge, this is the first report of bilateral proptosis secondary to VPS obstruction. This case highlights the value of key clinical findings and limitations of neuroimaging.

Keywords: obstruction; proptosis; ventriculoperitoneal shunt.

Publication types

Case Reports

Grants and funding

Funding None.