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Case (4): 2nd case of frequent failed revisions A long-term delay for 1). frequent incorrect diagnoses And 2). treatments of shunt and revision failures (Revisional treatments of them) Website:www.csfneurosurg.com


Case 4:Shunt infection(1) 1. 2. 3. 4.

Case1:Male, 21 years old; After first shunt From July,2009 to May,2011: a normal life of 2 years. Symptom Before shunt:dizziness at sometimes After shunt: a normal life Before shunt at July 6,2009

After shunt at Aug 25,2009


Hydrocephalic symptoms recurring and worsening during two months of first shunting (delayed diagnosis) 1. May16,2011: dizziness recurred(Fig.1) 2. June 30,2011: worse dizziness; memory loss beginning; Blurred vision 3. July 6,2011: an intolerable feeling of suffering; Eyes unmovable but only looking downward; walking slowness; absent-minded looking; Much Less Speech and reluctant to answer questions ; insomnia and irritability; chest distress --- so being transferred to under neurologist care form neurosurgeon(fig.2) 4. July 19,2011: diagnosed as schizophrenia, Being in a mental hospital under Antipsychotic treatment for 5 days without any effect but even worsening: unable of feeding himself; frequently stopping chewing with much food in mouth; unable standing even with other’s help ,unable speech at all, sweating heavily on whole body; incontinence

Fig.1May16,2011

fig.2July 6,2011


No clinical improvement again later in the hospital of Neurosurgical center of China 1. July 25 to 27 July 25 to 27,2011(3 days):During waiting for Admission in emergency room: Body temperature going up to 38o ,and becoming coma twice 2. July 27,2011: Hydrocephalus recurred by a re-exam of brain CT(Fig.1). 3. July 28,2011:Indication of brain hernia by pupils ’asymmetry (L :R= 2.2 :2.5 (mm)),therefore, a shunt revision was performed by putting another shunt in the ventricle in emergency (fig.2) 4. Form July 29 to August15, 2011: Although the Ventricles became normal, there were not any improvement in clinical conditions

Fig.1 at July 27,2011

fig.2 July 29, 2011


Good results of neuroimagings from CSF neurosurgical treatment Feb 8,2011 After 6 months of treatment

April 24,2012 at discharge after 8 months of treatment


Good result of clinical behaviors from CSF neurosurgical treatment for 8 months August 15, 2011 Oct12,2011

April 24,2012

August 6,2012, Follow up

4 months after discharge


2nd case of ventriculo-peritoneal shunt infection of long-term delay for diagnosis and treatments