{"id":"01d80937-d339-4c3c-92ab-864991e1f505","slug":"chronic-csf-leak-from-lumbar-peritoneal-shunt-tract-a-case-report","title":"Chronic CSF leak from lumbar-peritoneal shunt tract: A case report","authors":["Ali Bakhsh","Mohamed Elmolla","Neil Buxton","Andrew Brodbelt"],"abstract":"Background: We describe a case of long-standing intracranial hypotension caused by an iatrogenic arachnoid diverticulum. This case illustrates two learning points. First, excessive CSF absorption may occur through an acquired arachnoid-epidural venous plexus at a dural defect. Second, a long-standing CSF leak may benefit from definitive surgical repair in the first instance. Case Description: A 55-year-old female, with known idiopathic intracranial hypertension, presented with disabling chronic low-pressure symptoms after having a lumboperitoneal shunt removed 5 years previously. MRI scan revealed a Chiari I malformation (CMI) and a small dural interruption at the L3/4 space. CT myelography confirmed the abnormality. Intraoperatively, a dural defect and arachnoid bleb with an overlying attachment of adipose tissue and a vessel were found. Postoperatively, the patient has marked resolution of her headaches and dizziness and is mobilizing independently. Conclusion: Excessive CSF absorption appears to have occurred through an acquired arachnoid-epidural venous plexus. A high index of suspicion for intracranial hypotension is required in patients with low pressure symptoms and a CMI.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/01d80937-d339-4c3c-92ab-864991e1f505/featured/hero-1781561330945.png","publishDate":"2022-05-20T00:00:00.000Z","doi":"10.25259/SNI_1084_2021","categories":["General Neurosurgery","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/01d80937-d339-4c3c-92ab-864991e1f505/pdf"}