• Michael Kim, Ilya Rybkin, Harrison Smith, Jared Cooper, and Michael Tobias.
• Department of Neurosurgery, Westchester Medical Center, Valhalla, New York, USA. Electronic address: Michael.Kim@wmchealth.org.
• World Neurosurg. 2019 Jan 1; 121: 127-130.

BackgroundHydrocephalus is an international disease process that is commonly treated surgically with a ventriculoperitoneal shunt. This device may be prone to malfunction, most commonly from obstruction, disconnection, or infection.Case DescriptionA 35-year-old female with hydrocephalus and a ventriculoperitoneal shunt presented with altered mental status and imaging concerning for a shunt malfunction. Intraoperatively, she was found to have bone growing over and compressing the proximal occluder of the shunt valve, causing a mechanical obstruction. Removal of the bone allowed for egress of cerebrospinal fluid and return of proper shunt function. The patient did well postoperatively.ConclusionHydrocephalus, ventriculoperitoneal shunts, and shunt revisions represent a significant health burden and cost. Here we present an unusual cause of a shunt malfunction caused by bony overgrowth.Copyright © 2018 Elsevier Inc. All rights reserved.

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