Giant acute epidural hematoma after ventriculoperitoneal shunt: a case report and literature review

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Citações na Scopus
4
Tipo de produção
article
Data de publicação
2014
Título da Revista
ISSN da Revista
Título do Volume
Editora
E-CENTURY PUBLISHING CORP
Citação
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, v.7, n.8, p.2355-2359, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Cerebrospinal fluid over-drainage is a common complication of ventriculoperitoneal devices. In terms of haemorrhage, subdural haematomas are usually more frequent lesions than epidural hematomas, which, more rarely, may also be seen after ventricular shunt procedures and may lead to rapid neurological decline and even death unless a surgical procedure can be promptly performed. This study reports the case of a 47 years-old Dandy Walker man, with clinical condition compatible with the diagnosis of normal pressure hydrocephalus submitted to a ventriculoperitoneal shunt with a high fixed pressure valve. After discharge, on the second day after the procedure, he presented with headache and impaired level of consciousness. At hospital admission he was in a coma and anisochoric. Underwent endotracheal intubation and a head CT, showed epidural hematoma. We performed emergency craniotomy to drain the hematoma, the patient died in the operating room despite resuscitation attempts. In conclusion, prompt diagnosis and emergency craniotomy is recommended in these cases. We must be aware of this possible evolution and maintain high suspicion besides a longer in-hospital observation after these procedures.
Palavras-chave
Hydrocephalus, epidural hematoma, ventriculoperitoneal shunt
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