Ventriculoperitoneal shunt malfunction due to pregnancy

A 27-year-old female was admitted to our department due to gait disturbance and disorientation. Computed tomography (CT) scan revealed symmetrical ventricular dilatation. She was pregnant at 25 weeks of gestation. At the age of 16 years, she had received a ventriculo-peritoneal (VP) shunt for hydrocephalus, induced by a cerebellar medulloblastoma. Neurological examination at the current admission showed that she was disoriented with ataxic gait and convergence nystagmus. Analysis of the cerebrospinal fluid showed normal cell composition. Magnetic resonance images (MRI) and Thalium-single photon emission tomography (Tl-SPECT) revealed no recurrence of the tumor. The radio-isotope shunt flow study showed there was no obstruction of the shunt tube or retardation of intraabdominal diffusion. The patient was diagnosed as having shunt malfunction without obstruction of the shunt tube. We performed pumping of a flushing device for the shunt system. As a result her symptom was gradually improved. The follow-up MRI, 20 days after the using, showed complete disappearance of hydrocephalus. She was discharged from our hospital 1 month later. She continued pumping of the flushing device by herself at home. Three months later, she delivered a healthy infant by vaginal labor. She has not need to do pumping after that. And MRI showed no sign of hydrocephalus.