The pathophysiological mechanisms related to aging of the material of a ventriculoperitoneal (VP) shunt and how mechanical stresses and mechanical traction applied to the VP shunt catheter contributed to the development of torticollis are discussed. We report a 14-year-old boy with torticollis developing as a late complication 12 years after placement of a left VP shunt for the treatment of aqueductal stenosis. The shunt tube and the surrounding fibrocalcified band were removed, and the patient's torticollis resolved completely without recurrence. Biomechanical dysfunction of shunt material with resultant tethering at the most mobile part of the shunt tubing (neck) in a growing child can lead to the development of torticollis. To our knowledge this is the first report of this VP shunt complication.
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