Case Presentation: A 14-year-old female with a history of hydrocephalus status-post ventriculoatrial (VA) shunt placement five years prior presented for acute lethargy characterized by difficulty waking her from sleep. Vital signs were T 36.6 C, pulse 72, respirations 20, BP 148/97, and SpO2 100% with exam notable for lethargy, spontaneous eye and limb movement, pupils […]