A case of recurrent flight-induced cerebrospinal fluid shunt overdrainage

Abstract

Shunted patients often complain of headaches after flights. The effect of air travel on shunt systems is unknown. We describe the case of a patient with longstanding hydrocephalus, who suffered flight-induced clinical deterioration and shunt overdrainage in two independent occasions. The patient, clinically stable for 1.5 and 5 years before each episode, reported severe headaches starting during the descent stages of the air travel. On both occasions, brain MRI imaging demonstrated pronounced ventricular size reduction. This case suggests that flight-induced shunt overdrainage can occur and should be suspected in patients with prolonged headaches and/or clinical deterioration triggered by air travel.

Keywords:

• Air travel
• cerebrospinal fluid
• hydrocephalus
• shunt overdrainage
• ventriculoperitoneal shunt

Disclosure statement

LD is supported by an NIHR Academic Clinical Fellowship and was the recipient of a research fellowship sponsored by B. Braun. MSM serves on the advisory board for Allergan, Novartis, Eli Lilly, Autonomic Technologies Inc and TEVA and has received payment for the development of educational presentations from Allergan, electroCore, Eli Lilly, Novartis and TEVA. AKT research time was supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. LDW has received honoraria from and served on advisory boards for Medtronic, B. Braun and Codman. The other authors have no disclosures to report.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article.

Informed consent

The patient has consented to the submission of this case report for publication.