An 18-year-old male with a history of severe traumatic brain injury developed severe hydrocephalus (Fig. 1, asterisks) after bilateral decompressive craniectomy, as shown by transcranial ultrasound (TCU, Fig. 1A) and cranial computed tomography (CT, Fig. 1B). Subsequently, the patient underwent a one-stage bilateral cranioplasty and ventriculoperitoneal (VP) shunt placement. Postoperatively, a progressive reduction in lateral ventricle size was observed on serial TCU (Fig. 1C) and CT as well (Fig. 1D). Notably, on abdominal ultrasound, the VP shunt catheter tip (Fig. 1E, arrow) was observed within the free peritoneal fluid (Fig. 1E, X-sign), indicating cerebrospinal fluid drainage. Ongoing monitoring of hydrocephalus and VP shunt function is an emerging application of point-of-care ultrasound that may aid in the early detection of system malfunction and expediting therapeutic interventions.

Figure 1

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