Introduction: The ventriculoperitoneal shunt is the most widely used surgical procedure for the treatment of hydrocephalus. It is associated with numerous mechanical complications, including distal catheter migration. Case report: We present a case in which the peritoneal catheter migrated into the scrotum. The patient was admitted with asymmetric scrotal swelling and, during hospitalization, developed shunt dysfunction and infection. The shunt was withdrawn and treatment was initiated for infection. At the end of treatment, a new shunt was implanted and bilateral hernioplasty was performed by the pediatric surgery team. At follow-up, there was adequate head circumference growth and no testicular abnormalities. Discussion: The procesus vaginalis is formed from the evagination of the peritoneum through the inguinal canal, leading to the descent of the testis during the embryonic period. The patency of this structure is the predisposing anatomical condition for the occurrence of inguinal hernia and for the migration of the shunt catheter into the scrotum. This condition is present in up to 80% of newborns and 60% of 1-year-old infants. The migration of the catheter commonly occurs until 12 months after surgery, typically on the right side. Conclusion: The presence of scrotal swelling in a patient with ventriculoperitoneal shunt should warrant the investigation of catheter migration.

Arachnoid cysts are benign intracranial lesions. They are usually located in the middle fossa, but can be found in other locations. We present a case of symptomatic Meckel cave (MC) arachnoid cyst -a very rare location -and a treatment strategy not elsewhere described before for this condition. A 54-year-old female with trigeminal neuralgia with previous history of radiofrequency rhizotomy treatment 6 years before admission had been experiencing pain recurrence with progression, which required successive increases in carbamazepine dosage. Magnetic Resonance Imaging (MRI) showed dilatation of the right MC with extension to the petrous apex. The lesion was compatible with arachnoid cyst, and due to the worsening of the clinical condition, surgical treatment was chosen. Percutaneous puncture of the cyst through the foramen ovale with injection of intracystic fibrin sealant was performed. The patient woke up from anesthesia with pain improvement and was discharged asymptomatic the next day. After 12 months of follow-up, she remained pain-free. In the literature review, we found only eight cases reported as MC arachnoid cyst. These are likely to progress and become symptomatic owing to their communication with the subarachnoid space and a unidirectional valve mechanism. Pain improvement with this technique is probably secondary to the interruption of these mechanisms. ResumoOs cistos aracnoides são lesões intracranianas benignas. Geralmente estão localizados na fossa média, mas podem ser encontrados em outros locais. Apresentamos um caso de cisto aracnoide sintomático no cavum de Meckel (CM)localização muito rarae uma estratégia de tratamento nunca antes descrita para esta condição. Uma mulher de 54 anos com neuralgia do trigêmeo e histórico de tratamento com rizotomia por Keywords ► Meckel cave ► arachnoid cyst ► petrous apex cephaloceles ► trigeminal neuralgia ► percutaneous treatment