Recurrent symptomatic pleural effusion due to a ventriculopleural shunt.

Ventriculopleural shunts are uncommonly used for the treatment of normal pressure hydrocephalus in adults. Pleural effusion has been reported to complicate the course of these ventriculopleural shunts in children. The pleural effusion should typically resemble the cerebrospinal fluid unless frankly infected. There are few good data on the nature of the pleural effusion. We, report a case of recurrent right-sided pleural effusion, 2 years after a ventriculopleural shunt insertion, for normal pressure hydrocephalus with no evidence of an underlying infection. The effusion abated after ligation of the shunt. We discuss the possible mechanisms in the development of the effusion. It is important to be aware of this unlikely complication of an uncommon procedure. Recognizing the origin of the pleural effusion can help in instituting close follow-up and early referral for revision of the ventriculopleural shunt.