Abstract

A 62-year-old woman admitted to our hospital because of a progressive disorder of consciousness within 2 days. Four months before admission, the patient underwent a laparoscopic repair of perforated gastric ulcer at a local hospital. The patient recovered well after the surgery and was successfully discharged. However, she experienced a deteriorated mentality with memory loss, and cranial computed tomography (CT) revealed communicating hydrocephalus. Subsequently, one month before admission, the patient received a Ventriculoperitoneal (VP) shunt at the local hospital with a good outcome. On physical examination at admission, the patient was drowsy. The rebound of the shunt reservoir was not abnormal (Codman valve pressure was 100 mmHg), and there was no subcutaneous swelling behind the ear. It was difficult to track the entire distal shunt catheter under the subcutaneous tunnel.