Delayed intracerebral and subdural hematomas after ventriculo-peritoneal shunt in a child: A case report and review of the literature

Coulibaly, Oumar; Dama, Mahamadou; Diallo, O.; Li, G.; Sogoba, Youssouf; Kanikomo, Drissa

doi:10.1016/j.neuchi.2016.01.003

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…Associated arterial and venous infarcts are not uncommon. Non-accidental injury must also be considered in infants where there are bilateral subdural collections, particularly of differing ages ( 28 , 54 ); however, one must also keep in mind that there are other medical and procedure-related causes of subdural hematoma ( 53 , 55 – 58 ).…”

Section: Cranial and Spinal Anatomical Differences And Implications Fmentioning

confidence: 99%

Anatomical and Physiological Differences between Children and Adults Relevant to Traumatic Brain Injury and the Implications for Clinical Assessment and Care

Figaji

2017

Front. Neurol.

138

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General and central nervous system anatomy and physiology in children is different to that of adults and this is relevant to traumatic brain injury (TBI) and spinal cord injury. The controversies and uncertainties in adult neurotrauma are magnified by these differences, the lack of normative data for children, the scarcity of pediatric studies, and inappropriate generalization from adult studies. Cerebral metabolism develops rapidly in the early years, driven by cortical development, synaptogenesis, and rapid myelination, followed by equally dramatic changes in baseline and stimulated cerebral blood flow. Therefore, adult values for cerebral hemodynamics do not apply to children, and children cannot be easily approached as a homogenous group, especially given the marked changes between birth and age 8. Their cranial and spinal anatomy undergoes many changes, from the presence and disappearance of the fontanels, the presence and closure of cranial sutures, the thickness and pliability of the cranium, anatomy of the vertebra, and the maturity of the cervical ligaments and muscles. Moreover, their systemic anatomy changes over time. The head is relatively large in young children, the airway is easily compromised, the chest is poorly protected, the abdominal organs are large. Physiology changes—blood volume is small by comparison, hypothermia develops easily, intracranial pressure (ICP) is lower, and blood pressure normograms are considerably different at different ages, with potentially important implications for cerebral perfusion pressure (CPP) thresholds. Mechanisms and pathologies also differ—diffuse injuries are common in accidental injury, and growing fractures, non-accidental injury and spinal cord injury without radiographic abnormality are unique to the pediatric population. Despite these clear differences and the vulnerability of children, the amount of pediatric-specific data in TBI is surprisingly weak. There are no robust guidelines for even basics aspects of care in children, such as ICP and CPP management. This is particularly alarming given that TBI is a leading cause of death in children. To address this, there is an urgent need for pediatric-specific clinical research. If this goal is to be achieved, any clinician or researcher interested in pediatric neurotrauma must be familiar with its unique pathophysiological characteristics.

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Section: Cranial and Spinal Anatomical Differences And Implications Fmentioning

confidence: 99%

Anatomical and Physiological Differences between Children and Adults Relevant to Traumatic Brain Injury and the Implications for Clinical Assessment and Care

Figaji

2017

Front. Neurol.

138

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“…SDHs among these are more common. 6,7 SDHs can occur in up to 2 to 17% patients with cerebrospinal fluid diversion procedures. 8 Mechanisms to explain formation of intracranial hematomas are not precisely A Rare Case Report of Simultaneous Occurrence of Chronic Subdural Hematoma and Acute Extradural Hematoma Yadav, Prasad defined yet, but some concepts have been postulated.…”

Section: Discussionmentioning

confidence: 99%

“… 8 Other causes may be bleeding disorders or use of anticoagulants. 6 7 8 Formation of EDH following shunt surgeries is extremely rare. It may be at the surgical site or distant from the surgical site.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case Report of Simultaneous Occurrence of Chronic Subdural Hematoma and Acute Extradural Hematoma in a Patient after Multiple Ventriculoperitoneal Shunt Surgeries

Yadav,

Prasad

2023

Asian J Neurosurg

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Ventriculoperitoneal (VP) shunt surgeries are common neurosurgical procedure for hydrocephalus. Subdural hematoma (SDH) and extradural hematoma (EDH) are rare but potentially life-threatening complications following VP shunt surgeries. We are describing probably the first case in which a 12-year-old boy presented to the emergency room in altered sensorium and gradual onset quadriparesis following multiple shunt revision procedures done in an outside hospital. Computed tomography head showed chronic right-sided frontotemporoparietal chronic SDH and parietal dominant EDH simultaneously with multiple shunt systems in ventricles. Patient was taken for surgery in emergency and emergent evacuation of hematoma was done. Patient improved in the postoperative period. In this case report we will make an attempt to describe a rare complication of VP shunt surgery and possible mechanisms responsible for it.

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“…Technically, ETV is considered to be simple, fast and safe, compared to shunt diversion associated to few complications such shunt infections or malfunctions, under or over drainage, intracranial haemorrhage or hematoma, seizures or abdominal complications [7].…”

Section: O Coulibaly Et Al World Journal Of Neurosciencementioning

confidence: 99%

Bilateral Chronic Subdural Hematoma after Endoscopic Third Ventriculostomy in a Child: A Case Report and Review of the Literature

Coulibaly¹,

Diallo²,

Dama³

et al. 2018

WJNS

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Hydrocephalus had been managed by ventriculoperitoneal shunt (VPS) or endoscopic third ventriculostomy (ETV) since several years. But these two different technics had some complications that must be managed promptly to avoid eventual fatal evolution. Chronic subdural hematomas after ETV is among these complications and is a very rarely situation observed in our department. This rare event associated with malaria in a child is considered to have a high mortality. Here we report a rare case of bilateral chronic subdural hematoma occurring in a 4-month-old boy after ETV and we discuss the likely pathogenesis and the difficulties of management.

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Delayed intracerebral and subdural hematomas after ventriculo-peritoneal shunt in a child: A case report and review of the literature

Cited by 5 publications

References 11 publications

Anatomical and Physiological Differences between Children and Adults Relevant to Traumatic Brain Injury and the Implications for Clinical Assessment and Care

Anatomical and Physiological Differences between Children and Adults Relevant to Traumatic Brain Injury and the Implications for Clinical Assessment and Care

A Rare Case Report of Simultaneous Occurrence of Chronic Subdural Hematoma and Acute Extradural Hematoma in a Patient after Multiple Ventriculoperitoneal Shunt Surgeries

Bilateral Chronic Subdural Hematoma after Endoscopic Third Ventriculostomy in a Child: A Case Report and Review of the Literature

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