COMPLETE MIGRATION OF PERITONEAL SHUNT TUBING TO THE SCALP

The entire length of distal tubing from a ventriculoperitoneal shunt w as found to have migrated into the subgaleal space, and resulted in a shunt obstruction. Upward migration of distal shunt catheters has rare ly been reported, but probably involves patient motion that creates a ''windlass'' effect. Cephaled migration requires a potential space (su bgaleal or ventricular) and no resistance to movement of the tubing. T his complication can be prevented by securing the shunt near the site of motion.