Unusual migration of proximal tip of ventriculoperitoneal shunt - CT

26 year old male patient with post traumatic hydrocephalus treated with ventriculoperitoneal shunt axial CT sectio at hte level of third ventricle showing tubular hyperdense structure (arrow) suggestive of VP shunt.

Axial section at the level of basal cisterns showing the VP shunt catheter in the suprasellar structures.

Sagittal reformatted image showing the catheter tip is situated at the roof of the sella.

Discussion:

• There are many incidents of unusual migration of the shunt tip in to various parts of the body. 
• Usually it is the distal or the peritoneal catheter that migrates after breakage or disconnection into many locations such as the scalp, heart, anus/rectum, urethral, knee, umbilicus, chest, pleural cavity, inguinal canal and scrotum.
• Complete migration of the shunt in to the ventricles have been reported.
• This might be the first case of shunt migration in to the suprasellar region as far as my knowledge is concerned.