{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:49Z","timestamp":1776096469504,"version":"3.50.1"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,1,26]]},"abstract":"\n BACKGROUND<\/jats:title>\n Malresorptive hydrocephalus occurs when CSF is inadequately absorbed, often following surgery. Ventriculoperitoneal (VP) shunt implantation is a well-established intervention to manage hydrocephalus by diverting excess CSF to the peritoneal cavity.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n This case report describes a rare complication following VP shunt implantation in a 62-year-old male patient with malresorptive hydrocephalus after prior aneurysm clipping. Despite laparoscopic intraoperative confirmation of correct intraperitoneal VP shunt catheter placement, postoperative imaging revealed migration of the shunt catheter into the right heart ventricle, having perforated the internal jugular vein during its insertion. The catheter formed a knot within the venous system, requiring a combined effort by surgeons of various specialties for safe removal and repositioning. After successful shunt repositioning, the patient\u2019s hydrocephalus resolved with marked improvement in clinical symptoms.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case highlights the need for early recognition of shunt complications via imaging and multispecialty management.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25607<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25607","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T06:29:06Z","timestamp":1769408946000},"source":"Crossref","is-referenced-by-count":0,"title":["A complicated case of ventriculoperitoneal shunt migration into the right heart ventricle after malresorptive hydrocephalus: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Hansen","family":"Nele","sequence":"first","affiliation":[{"name":"Endomin Neurosurgical Clinic, Clinic Hirslanden, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4472-1563","authenticated-orcid":true,"given":"Riccardo","family":"Gaeckle","sequence":"additional","affiliation":[{"name":"Endomin Neurosurgical Clinic, Clinic Hirslanden, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4718-7058","authenticated-orcid":true,"given":"Reuben","family":"Christopher","sequence":"additional","affiliation":[{"name":"Endomin Neurosurgical Clinic, Clinic Hirslanden, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Reisch","sequence":"additional","affiliation":[{"name":"Endomin Neurosurgical Clinic, Clinic Hirslanden, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolai J.","family":"Hopf","sequence":"additional","affiliation":[{"name":"Endomin Neurosurgical Clinic, Clinic Hirslanden, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7904-5572","authenticated-orcid":true,"given":"Alberto","family":"Consuegra","sequence":"additional","affiliation":[{"name":"Endomin Neurosurgical Clinic, Clinic Hirslanden, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Semin Pediatr Neurol","first-page":"9","article-title":"A contemporary definition and classification of hydrocephalus","volume":"16","author":"Rekate","year":"2009","unstructured":"Rekate HL.A contemporary definition and classification of hydrocephalus. Semin Pediatr Neurol. 2009;16(1):9-15."},{"key":"bib2","series-title":"World Neurosurg","first-page":"129","article-title":"Management of hydrocephalus with ventriculoperitoneal shunts: review of 109 cases of children","volume":"96","author":"Dakurah","year":"2016","unstructured":"Dakurah TKAdams FIddrissu MManagement of hydrocephalus with ventriculoperitoneal shunts: review of 109 cases of children. World Neurosurg. 2016;96:129-135."},{"key":"bib3","series-title":"Clin Neurol Neurosurg","first-page":"26","article-title":"Laparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: a systematic review and meta-analysis","volume":"140","author":"Phan","year":"2016","unstructured":"Phan SLiao JJia FLaparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2016;140:26-32."},{"issue":"1-2","key":"bib4","series-title":"World Neurosurg","first-page":"155","article-title":"Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience","volume":"78","author":"Reddy","year":"2012","unstructured":"Reddy GKBollam PCaldito G.Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience. World Neurosurg. 2012;78(1-2):155-163."},{"issue":"2","key":"bib5","series-title":"World Neurosurg","first-page":"404","article-title":"Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus","volume":"81","author":"Reddy","year":"2014","unstructured":"Reddy GKBollam PCaldito G.Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg. 2014;81(2):404-410."},{"key":"bib6","series-title":"World Neurosurg","first-page":"29","article-title":"Intracardial catheter migration of a ventriculoperitoneal shunt: pathophysiology and interdisciplinary management","volume":"129","author":"Adib","year":"2019","unstructured":"Adib SLescan MRenovanz MIntracardial catheter migration of a ventriculoperitoneal shunt: pathophysiology and interdisciplinary management. World Neurosurg. 2019;129:29-34."},{"issue":"2 Suppl Pediatrics","key":"bib7","series-title":"J Neurosurg","first-page":"206","article-title":"Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature","volume":"100","author":"Fewel","year":"2004","unstructured":"Fewel MEGarton HJL.Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg. 2004;100(2 Suppl Pediatrics):206-211."},{"key":"bib8","series-title":"World Neurosurg","first-page":"585.e5","article-title":"Comparison of long-term outcomes between programmable and non-programmable cerebrospinal fluid shunt valves","volume":"92","author":"Lyon","year":"2016","unstructured":"Lyon KABan VSBedros NComparison of long-term outcomes between programmable and non-programmable cerebrospinal fluid shunt valves. World Neurosurg. 2016;92:585.e5-585.e11."},{"key":"bib9","series-title":"Surg Neurol Int","first-page":"77","article-title":"Delayed peritoneal shunt catheter migration into the pulmonary artery with indolent thrombosis: a case report and narrative review","volume":"13","author":"Patel","year":"2022","unstructured":"Patel MSZhang JKKhan ASRDelayed peritoneal shunt catheter migration into the pulmonary artery with indolent thrombosis: a case report and narrative review. Surg Neurol Int. 2022;13:77."},{"issue":"4","key":"bib10","series-title":"Cureus","first-page":"e7779","article-title":"Spontaneous migration of a ventriculoperitoneal shunt into the venous system: a multidisciplinary approach","volume":"12","author":"Finneran","year":"2020","unstructured":"Finneran MMNardone EMarotta DASmith GBGordhan A.Spontaneous migration of a ventriculoperitoneal shunt into the venous system: a multidisciplinary approach. Cureus. 2020;12(4):e7779."},{"issue":"6","key":"bib11","series-title":"J Neurosurg Case Lessons","first-page":"CASE24127","article-title":"Ventriculoperitoneal shunt tube migration into the heart and pulmonary artery: successful tube removal. Illustrative case","volume":"8","author":"Tokuda","year":"2024","unstructured":"Tokuda NYamada SYokoyama SNakagawa I.Ventriculoperitoneal shunt tube migration into the heart and pulmonary artery: successful tube removal. Illustrative case. J Neurosurg Case Lessons. 2024;8(6):CASE24127."},{"issue":"3","key":"bib12","series-title":"Neurosurgery","first-page":"819","article-title":"Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report","volume":"51","author":"Frazier","year":"2002","unstructured":"Frazier JLWang PPPatel SHUnusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report. Neurosurgery. 2002;51(3):819-822."},{"issue":"4","key":"bib13","series-title":"J Cardiovasc Thorac Res","first-page":"263","article-title":"Upward spontaneous migration of ventriculoperitoneal shunt into the heart: a case report summary","volume":"14","author":"Ghaffari","year":"2022","unstructured":"Ghaffari SHashemzadeh KSamadi MMolaei ASadeghi SJamei Khosroshahi AJ.Upward spontaneous migration of ventriculoperitoneal shunt into the heart: a case report summary. J Cardiovasc Thorac Res. 2022;14(4):263-267."},{"issue":"10","key":"bib14","series-title":"Neurol Med Chir (Tokyo)","first-page":"945","article-title":"Migration of a distal ventriculoperitoneal shunt catheter into the internal jugular vein and heart through the external jugular vein: case report","volume":"50","author":"Kano","year":"2010","unstructured":"Kano TKurosaki SIwasa SWada H.Migration of a distal ventriculoperitoneal shunt catheter into the internal jugular vein and heart through the external jugular vein: case report. Neurol Med Chir (Tokyo). 2010;50(10):945-948."},{"issue":"4","key":"bib15","series-title":"Childs Nerv Syst","first-page":"703","article-title":"Transcardiac migration of ventriculoperitoneal shunt requiring open cardiac surgery: case report and review of the literature","volume":"33","author":"Ralston","year":"2017","unstructured":"Ralston AJohnson AZiemer GFrim DM.Transcardiac migration of ventriculoperitoneal shunt requiring open cardiac surgery: case report and review of the literature. Childs Nerv Syst. 2017;33(4):703-707."},{"issue":"3","key":"bib16","series-title":"J Korean Neurosurg Soc","first-page":"170","article-title":"Upward migration of distal ventriculoperitoneal shunt catheter into the heart: case report","volume":"44","author":"Chong","year":"2008","unstructured":"Chong JYKim JMCho DCKim CH.Upward migration of distal ventriculoperitoneal shunt catheter into the heart: case report. J Korean Neurosurg Soc. 2008;44(3):170-173."},{"issue":"5","key":"bib17","series-title":"J Neurosurg","first-page":"1058","article-title":"Laparoscopically assisted ventriculoperitoneal shunt placement: a prospective randomized controlled trial","volume":"122","author":"Schucht","year":"2015","unstructured":"Schucht PBanz VTrochsler MLaparoscopically assisted ventriculoperitoneal shunt placement: a prospective randomized controlled trial. J Neurosurg. 2015;122(5):1058-1067."},{"issue":"1","key":"bib1","series-title":"Semin Pediatr Neurol","first-page":"9","article-title":"A contemporary definition and classification of hydrocephalus","volume":"16","author":"Rekate","year":"2009","unstructured":"Rekate HL.A contemporary definition and classification of hydrocephalus. Semin Pediatr Neurol. 2009;16(1):9-15."},{"key":"bib2","series-title":"World Neurosurg","first-page":"129","article-title":"Management of hydrocephalus with ventriculoperitoneal shunts: review of 109 cases of children","volume":"96","author":"Dakurah","year":"2016","unstructured":"Dakurah TKAdams FIddrissu MManagement of hydrocephalus with ventriculoperitoneal shunts: review of 109 cases of children. World Neurosurg. 2016;96:129-135."},{"key":"bib3","series-title":"Clin Neurol Neurosurg","first-page":"26","article-title":"Laparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: a systematic review and meta-analysis","volume":"140","author":"Phan","year":"2016","unstructured":"Phan SLiao JJia FLaparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2016;140:26-32."},{"issue":"1-2","key":"bib4","series-title":"World Neurosurg","first-page":"155","article-title":"Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience","volume":"78","author":"Reddy","year":"2012","unstructured":"Reddy GKBollam PCaldito G.Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience. World Neurosurg. 2012;78(1-2):155-163."},{"issue":"2","key":"bib5","series-title":"World Neurosurg","first-page":"404","article-title":"Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus","volume":"81","author":"Reddy","year":"2014","unstructured":"Reddy GKBollam PCaldito G.Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg. 2014;81(2):404-410."},{"key":"bib6","series-title":"World Neurosurg","first-page":"29","article-title":"Intracardial catheter migration of a ventriculoperitoneal shunt: pathophysiology and interdisciplinary management","volume":"129","author":"Adib","year":"2019","unstructured":"Adib SLescan MRenovanz MIntracardial catheter migration of a ventriculoperitoneal shunt: pathophysiology and interdisciplinary management. World Neurosurg. 2019;129:29-34."},{"issue":"2 Suppl Pediatrics","key":"bib7","series-title":"J Neurosurg","first-page":"206","article-title":"Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature","volume":"100","author":"Fewel","year":"2004","unstructured":"Fewel MEGarton HJL.Migration of distal ventriculoperitoneal shunt catheter into the heart. Case report and review of the literature. J Neurosurg. 2004;100(2 Suppl Pediatrics):206-211."},{"key":"bib8","series-title":"World Neurosurg","first-page":"585.e5","article-title":"Comparison of long-term outcomes between programmable and non-programmable cerebrospinal fluid shunt valves","volume":"92","author":"Lyon","year":"2016","unstructured":"Lyon KABan VSBedros NComparison of long-term outcomes between programmable and non-programmable cerebrospinal fluid shunt valves. World Neurosurg. 2016;92:585.e5-585.e11."},{"key":"bib9","series-title":"Surg Neurol Int","first-page":"77","article-title":"Delayed peritoneal shunt catheter migration into the pulmonary artery with indolent thrombosis: a case report and narrative review","volume":"13","author":"Patel","year":"2022","unstructured":"Patel MSZhang JKKhan ASRDelayed peritoneal shunt catheter migration into the pulmonary artery with indolent thrombosis: a case report and narrative review. Surg Neurol Int. 2022;13:77."},{"issue":"4","key":"bib10","series-title":"Cureus","first-page":"e7779","article-title":"Spontaneous migration of a ventriculoperitoneal shunt into the venous system: a multidisciplinary approach","volume":"12","author":"Finneran","year":"2020","unstructured":"Finneran MMNardone EMarotta DASmith GBGordhan A.Spontaneous migration of a ventriculoperitoneal shunt into the venous system: a multidisciplinary approach. Cureus. 2020;12(4):e7779."},{"issue":"6","key":"bib11","series-title":"J Neurosurg Case Lessons","first-page":"CASE24127","article-title":"Ventriculoperitoneal shunt tube migration into the heart and pulmonary artery: successful tube removal. Illustrative case","volume":"8","author":"Tokuda","year":"2024","unstructured":"Tokuda NYamada SYokoyama SNakagawa I.Ventriculoperitoneal shunt tube migration into the heart and pulmonary artery: successful tube removal. Illustrative case. J Neurosurg Case Lessons. 2024;8(6):CASE24127."},{"issue":"3","key":"bib12","series-title":"Neurosurgery","first-page":"819","article-title":"Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report","volume":"51","author":"Frazier","year":"2002","unstructured":"Frazier JLWang PPPatel SHUnusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart: case report. Neurosurgery. 2002;51(3):819-822."},{"issue":"4","key":"bib13","series-title":"J Cardiovasc Thorac Res","first-page":"263","article-title":"Upward spontaneous migration of ventriculoperitoneal shunt into the heart: a case report summary","volume":"14","author":"Ghaffari","year":"2022","unstructured":"Ghaffari SHashemzadeh KSamadi MMolaei ASadeghi SJamei Khosroshahi AJ.Upward spontaneous migration of ventriculoperitoneal shunt into the heart: a case report summary. J Cardiovasc Thorac Res. 2022;14(4):263-267."},{"issue":"10","key":"bib14","series-title":"Neurol Med Chir (Tokyo)","first-page":"945","article-title":"Migration of a distal ventriculoperitoneal shunt catheter into the internal jugular vein and heart through the external jugular vein: case report","volume":"50","author":"Kano","year":"2010","unstructured":"Kano TKurosaki SIwasa SWada H.Migration of a distal ventriculoperitoneal shunt catheter into the internal jugular vein and heart through the external jugular vein: case report. Neurol Med Chir (Tokyo). 2010;50(10):945-948."},{"issue":"4","key":"bib15","series-title":"Childs Nerv Syst","first-page":"703","article-title":"Transcardiac migration of ventriculoperitoneal shunt requiring open cardiac surgery: case report and review of the literature","volume":"33","author":"Ralston","year":"2017","unstructured":"Ralston AJohnson AZiemer GFrim DM.Transcardiac migration of ventriculoperitoneal shunt requiring open cardiac surgery: case report and review of the literature. Childs Nerv Syst. 2017;33(4):703-707."},{"issue":"3","key":"bib16","series-title":"J Korean Neurosurg Soc","first-page":"170","article-title":"Upward migration of distal ventriculoperitoneal shunt catheter into the heart: case report","volume":"44","author":"Chong","year":"2008","unstructured":"Chong JYKim JMCho DCKim CH.Upward migration of distal ventriculoperitoneal shunt catheter into the heart: case report. J Korean Neurosurg Soc. 2008;44(3):170-173."},{"issue":"5","key":"bib17","series-title":"J Neurosurg","first-page":"1058","article-title":"Laparoscopically assisted ventriculoperitoneal shunt placement: a prospective randomized controlled trial","volume":"122","author":"Schucht","year":"2015","unstructured":"Schucht PBanz VTrochsler MLaparoscopically assisted ventriculoperitoneal shunt placement: a prospective randomized controlled trial. 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