We report a child with osteopetrosis, oxycephaly and Chiari type I malformation who presented with raised intracranial pressure. During cranial expansion surgery the patient developed sudden cardiac arrest which we believe was probably related to the Chiari malformation. The case highlights a previously unrecognized association between osteopetrosis, craniosynostosis and a persistently open fontanelle at age 4 years. In addition it supports the existing literature in emphasizing the need for careful preoperative work up, choice of approach and operative technique in children with complex craniosynostosis and Chiari malformation.

The formation of a brain abscess as a result of a cerebrospinal fluid shunt complication is extremely rare in the literature with only 7 cases reported in the last 20 years. We report a patient that developed a brain abscess adjacent to a functioning ventricular catheter in the presence of shunt infection by another pathogen. Clinicians should consider this complication in any shunted patient with clinical features of infection and suggestive changes on imaging however subtle. Expedited standard management for the abscess and the CSF shunt infection, if present, should be employed. Removal of all non-functioning catheters should be encouraged.