Long-term air-exposed functioning hydrocephalus valve with no infection.

One of the reasons for shunt infection is valve erosion through the skin. In such cases, it is common practice to instantly relocate the shunt to avoid infection. We present a 77-year-old female patient with a 15-month history of hydrocephalus valve extrusion. Despite her poor mental status, clinical condition and hygiene, and the prolonged extrusion period, she developed neither a local nor a cerebrospinal fluid (CSF) infection. The patient was ultimately treated with shunt removal and repositioning. An extensive literature review revealed no previous report of such a case. This case indicates that under rare conditions, central nervous system (CNS) implantable devices might not become contaminated and may remain functional, even if they remain exposed for prolonged periods.