BILATERAL SUBDURAL HEMATOMA AFTER VENTRICULOPERITONEAL SHUNT SURGERY

Year 2019, Volume: 10 Issue: 1, 26 - 28, 01.01.2019

Ulaş Yüksel İbrahim Akkurt Mustafa Ogden Bülent Bakar Semih Keskil

https://doi.org/10.33706/jemcr.550572

Abstract

Introduction: Bilateral subdural hematoma (SDH) following ventriculoperitoneal
(V/P) shunt application was discussed in present case.

Case Report: 8-year-old girl was operated due to thoracolumbar meningomyelocele
immediately after birth. V/ P shunt was inserted in right posterior parietal
region due to hydrocephalus when she was 3 month-old. At age of 3 years, V/P shunt
dysfunction was considered, and second V/P shunt was inserted in left posterior
parietal region. One year after, patient was reevaluated, and CT images showed
bilateral subacute SDH.  Hematoma evacuation
was not considered, but right ventricular catheter was ligated. At four years
follow-up, no additional neurological impairment was observed in patient and CT
scan revealed that SDHs were retracted greatly.

Concusion:
It should be
kept in mind that SDH could develop after V/P shunt surgery. Additionally, it
could be said that one of most important factor in determination of treatment
of this complication was primarily neurological examination findings of
patient.

Keywords

bilateral subdural hematoma, hydrocephalus

References

• 1. McGirt MJ, Leveque JC, Wellons JC 3rd, Villavicencio AT, Hopkins JS, Fuchs HE, et al. Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg. 2002; 36: 248-55.
• 2. Potineni LB, Hartin CW Jr, Gemme S, Caty MG, Bass KD. Laparoscopic assessment of a migrated ventriculoperitoneal shunt into an inguinal hernia. J Laparoendosc Adv Surg Tech A. 2012; 22: 301-3.
• 3. Fukuhara T, Vorster SJ, Luciano MG. Critical shunt-induced subdural hematoma treated with combined pressure-programmable valve implantation and endoscopic third ventriculostomy. Pediatr Neurosurg. 2000; 33: 37-42.
• 4. Hayes J, Roguski M, Riesenburger RI. Rapid resolution of an acute subdural hematoma by increasing the shunt valve pressure in a 63-year-old man with normal-pressure hydrocephalus with a ventriculoperitoneal shunt: a case report and literature review. J Med Case Rep. 2012; 6: 393.
• 5. Stein SC, Guo W. Have we made progress in preventing shunt failure? A critical analysis. J Neurosurg Pediatr. 2008; 1: 40-7.
• 6. Taha MM. Armored brain in patients with hydrocephalus after shunt surgery: review of the literatures. Turk Neurosurg. 2012; 22: 407-10.
• 7. Castellani RJ, Mojica-Sanchez G, Schwartzbauer G, Hersh DS. Symptomatic Acute-on-Chronic Subdural Hematoma: A Clinicopathological Study. Am J Forensic Med Pathol. 2017; 38: 126-30.
• 8. Louzada PR, Requejo PR, Barroso MV, Vaitsman RP, Machado AL, Paiva MS, et al. Bilateral extradural haematoma after acute ventricular over-drainage. Brain Inj. 2012; 26: 95-100.
• 9. Mortazavi MM, Denning M, Yalcin B, Shoja MM, Loukas M, Tubbs RS. The intracranial bridging veins: a comprehensive review of their history, anatomy, histology, pathology, and neurosurgical implications. Childs Nerv Syst. 2013; 29: 1073-8.
• 10. Ludwig B, Nix W, Lanksch W. Computed tomography of the "armored brain". Neuroradiology. 1983; 25: 39-43.