Cranial nerve involvement as a complication of ventriculoperitoneal shunt - A case report and review

Isolated fourth ventricle is a rare complication of ventriculoperitoneal shunt insertion in patients with hydrocephalus. Fourth ventriculoperitoneal shunt is the main treatment for patients with symptomatic isolated fourth ventricle. Cranial nerves involvement is rarely seen after shunt insertion in the fourth ventricle. We report a patient who developed delayed fifth, sixth, and seventh cranial nerves deficit after the insertion of shunt in his fourth ventricle. The cause most probably was owing to delay penetration of stem by the tip of the ventricular catheter after decrease in volume of the patient's fourth ventricle. We revised the shunt and shortened the ventricular end. The patient's condition improved significantly.