Reversible Severe Brainstem Herniation and Obstructive Hydrocephalus from Cystoperitoneal Shunt Overdrainage.

We present a case of symptomatic intracranial hypotension secondary to CSF overdrainage from a cystoperitoneal shunt system. Brain MRI shows distortion of the midbrain with secondary occlusion of the cerebral aqueduct resulting in obstructive hydrocephalus. The symptoms, brainstem herniation, and hydrocephalus resolved after tie occlusion of the shunt.