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J Pediatr Intensive Care 2021; 10(04): 311-316
DOI: 10.1055/s-0040-1713677
Case Report

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

Deepti Verma 
1   Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore
,
David Chyi Yeu Low
2   Neurosurgical Service, Division of Surgery, KK Women's and Children's Hospital, Singapore, Singapore
,
Joel Kian Boon Lim
3   Children's Intensive Care Unit, Department of Pediatric Subspecialties, KK Women's and Children's Hospital, Singapore, Singapore
› Author Affiliations Funding None.
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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

proptosis - ventriculoperitoneal shunt - obstruction

Authors' Contributions

All authors participated in creating the content of the case report, editing, and providing final approval for submission. No undisclosed authors contributed to the case report.




Publication History

Received: 03 May 2020

Accepted: 20 May 2020

Article published online:
29 July 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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