Multiple Epidural Hematomas following Ventriculoperitoneal Shunt

Kalia, Kamal K.; Swift, Dale M.; Pang, Dachling

doi:10.1159/000120704

Cited by 30 publications

(30 citation statements)

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“…Hence, formation of acute SDH after ventricular decompression is well known in neurosurgical practice. Formation of EDH, however, is a rare complication of VP shunt surgery, with most reported cases in children[1] and young adults. This is thought to be due to the firm attachment of the dura to the skull in older adults.…”

Section: Discussionmentioning

confidence: 99%

Shunt site chronic calcified extradural hematoma: An avoidable complication

2014

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Extradural hematoma (EDH) after ventriculoperitoneal (VP) shunt procedure is a rare, dangerous but easily avoidable and manageable complication. It is more common in children and young adults presumably due to relatively lax adhesion of dura to calvarium. We report a case of an 18-year-old male with acqueductal stenosis who underwent VP shunt procedure. Three months later, a computed tomography (CT) scan was done for the complaints of intractable headache and altered sensorium which showed chronic calcified EDH near shunt site. The ventricular catheter was in position and the ventricles were decompressed. After surgical decompression of EDH his symptoms improved. We discuss the factors leading to formation of EDH, with stress on proper technique to prevent or minimize such an avoidable complication.

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Section: Discussionmentioning

confidence: 99%

Shunt site chronic calcified extradural hematoma: An avoidable complication

2014

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“…Besides, normal skull radiography does not preclude the presence of an EDH [1, 2, 3, 4]. In cases of children with a functioning ventriculoperitoneal shunting system, we believe that all skull fractures need a CT scan, because these children are more likely to develop intracranial hematomas due to the mechanism of continuous drainage of intraventricular cerebrospinal fluid and lowered intracranial pressure [10, 11, 12, 13, 14, 15, 16, 17, 18]. …”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of the spontaneous EDH formation is related to the rapid falling of intracranial pressure by an overdrainage of the cerebrospinal fluid, resulting in separation of the dura mater from the skull, and tearing of small dural vessels [10, 12, 13, 14, 15, 16]. According to Kalia et al [17], perhaps in some patients the skull to dura mater adhesion is less important than the dura mater to arachnoid adhesion, and an EDH might form instead of the more common subdural hematoma. It is known that the dura mater in children and young adults is less adherent to the skull than in older adults, explaining why most reported cases of postventriculostomy EDH occurred in children and young adults.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Acute Giant Epidural Hematoma in a Hydrocephalic Shunted Child

et al. 2000

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Extradural hematoma (EDH) is considered to be a rare complication of head trauma in children, and represents a serious and urgent pathology from which complete recovery can be expected if specialized treatment is instituted in time. In this article, the authors report the potential danger to a hydrocephalic shunted child who was apparently asymptomatic at the time of hospital admission with a mild head injury and developed an EDH of venous origin. This child had a rapid (time interval from injury to decerebrate posture of about 2 h), atypical (remained asymptomatic most of the time until abruptly deterioration) and fatal course, stressing the importance of early diagnosis and rapid therapy in order to avoid the death of the patient. The authors discuss the role of the ventriculoperitoneal shunting system in the lack of clinical symptoms associated with the presence of a giant EDH and a rapid and fatal course, and stress the importance of computed tomographic (CT) scanning in these patients, even if they are asymptomatic. If a skull fracture is suspected, a CT scan must be performed without delay.

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“…EH, as a complication of ventriculoperitoneal shunt surgery for the management of hydrocephalus, is a rare condition [3][4][5][6][7][8][9][10]16,19 . It often occurs in young patients 4,10,16,17,19 , and there are some anatomical regions (parietal and frontal) where the pathology is more frequently found.…”

Section: Discussionmentioning

confidence: 99%

“…It is a catastrophic complication of a relatively minor neurosurgical procedure. EH, as a complication of ventricular drainage, was first mentioned in 1941, by Olivecrona 1 ; since then other cases have seldom been reported [2][3][4][5][6][7][8][9][10][11][12][13][14][15] .…”

mentioning

confidence: 99%

Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

Pereira

Porto

Holanda³

et al. 1998

Arq. Neuro-Psiquiatr.

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ABSTRACT-Ventriculoperitoneal shunt operations represent the most used choice for treating hydrocephalus, although some related complications have been reported. Due to its rarity, potential dangers, and mortality rate, we present two cases of epidural hematoma following ventriculoperitoneal shunt, discussing its pathophysiology and prophylaxis.KEY WORDS: epidural hematoma, complications, cerebrospinal fluid shunts. Hematoma epidural após derivação ventriculoperitoneal: relato de dois casosRESUMO -No tratamento cirúrgico da hidrocefalia, a derivação ventriculoperitoneal é a mais usada, porém ocorrem várias complicações e dentre elas o hematoma epidural. Os autores relatam dois casos de hematoma epidural após cirurgia de derivacão ventriculoperitoneal e discutem sua provável fisiopatologia e profilaxia. PALAVRAS-CHAVE: hematoma epidural, complicações, derivações do líquido cefalorraquidiano.

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Multiple Epidural Hematomas following Ventriculoperitoneal Shunt

Cited by 30 publications

References 0 publications

Shunt site chronic calcified extradural hematoma: An avoidable complication

Shunt site chronic calcified extradural hematoma: An avoidable complication

Traumatic Acute Giant Epidural Hematoma in a Hydrocephalic Shunted Child

Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

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