Delayed brain abscess after bowel perforation by a subdural-peritoneal shunt

Placement of a subdural-peritoneal shunt is a common procedure in the treatment of external hydrocephalus. Abdominal complications such as bowel perforation are uncommon, and brain abscess formation following this event is even rarer. We describe the seventh case of spontaneous bowel perforation by a shunt catheter leading to brain abscess formation in a patient who presented with anal protrusion of the catheter. To our knowledge, this is the first case of delayed brain abscess formation occurring one month after catheter externalization. We discuss diagnosis, radiologic findings, and emphasize complete removal of the catheter, regardless of symptomatology, to avoid future brain abscess formation.