Post shunt meningeal fibrosis: Role of contrast enhanced MRI in differentiation from chronic subdural hematoma

Post shunt meningeal fibrosis is an uncommon complication following VP shunt insertion and it presents with a diagnostic dilemma. It is a rare post shunt entity that may mimic chronic subdural hematoma on unenhanced CT and MR. Thus it is important to recognize it before any therapeutic intervention is being considered. We present a case of 47 year male who underwent VP shunt insertion for tubercular hydrocephalus 4 years ago. He presented with chronic headache for 6 months for which MRI brain was done. MRI finding revealed post shunt meningeal fibrosis thus differentiating from chronic subdural hematoma and hence obviated surgical drainage.