Introduction: Cutis Verticis Gyrata (CVG) is a rare benign scalp condition characterized by the thickening of all cutaneous layers of the scalp, resulting in the formation of skin ridges and furrows. The exact etiology of CVG remains unclear, with hypotheses suggesting hormonal imbalances and genetic factors as potential causes. CVG predominantly affects postpubescent men at a male-to-female ratio of 4:1. Although well-documented in terms of clinical features, the neurosurgical considerations of CVG are less explored.
Methods: We present a case of a 47-year-old male patient with CVG and a history of neurosarcoidosis who developed hydrocephalus necessitating the placement of a ventriculoperitoneal (VP) shunt. The patient’s clinical presentation, surgical intervention, and complications were documented in accordance with CARE guidelines.
Results: The patient initially underwent a standard right VP shunt placement, which was uncomplicated. However, he later experienced symptoms of shunt malfunction and infection, requiring multiple revisions. The altered scalp anatomy due to CVG complicated the accurate placement and stability of the shunt, resulting in catheter migration. Ultimately, securing the valve and catheter to the skull with titanium plates and screws resolved the issue.
Conclusion : CVG’s unique anatomical challenges can significantly impact neurosurgical procedures such as VP shunt placement. Careful preoperative planning and securing the shunt system to the skull, rather than to soft tissue, are essential to avoid complications. Further research into CVG's mechanisms and its implications for various surgical procedures is necessary to improve patient outcomes.
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