Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

Pereira, Carlos Umberto; Porto, Marcus Wagner De Souza; Holanda, Rafael Rodrigues; Andrade, Wellington Torres de

doi:10.1590/s0004-282x1998000400017

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…An EDH can develop regionally; adjacently; or distantly, in a remote area that is removed from the operation site [ 1 ]. There are some reports of remote EDHs that occurred after a ventriculo-peritoneal shunt operation [ 3 4 5 6 7 8 9 10 11 12 13 14 ] or a decompressive craniectomy [ 15 16 ]. Few cases of postoperative remote EDHs after brain tumor surgery have been reported [ 2 17 18 19 20 21 22 23 ], especially in posterior fossa surgery [ 24 25 26 27 ].…”

Section: Introductionmentioning

confidence: 99%

Remote Postoperative Epidural Hematoma after Brain Tumor Surgery

Chung

Park

et al. 2015

Brain Tumor Res Treat

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A postoperative epidural hematoma (EDH) is a serious and embarrassing complication, which usually occurs at the site of operation after intracranial surgery. However, remote EDH is relatively rare. We report three cases of remote EDH after brain tumor surgery. All three cases seemed to have different causes of remote postoperative EDH; however, all patients were managed promptly and showed excellent outcomes. Although the exact mechanism of remote postoperative EDH is unknown, surgeons should be cautious of the speed of lowering intracranial pressure and implement basic procedures to prevent this hazardous complication of brain tumor surgery.

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Section: Introductionmentioning

confidence: 99%

Remote Postoperative Epidural Hematoma after Brain Tumor Surgery

Chung

Park

et al. 2015

Brain Tumor Res Treat

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“…The incidence of epidural hematoma after ventricular shunt operation was 5.6% in adults and 0% in children before the advent of valve-regulated shunt (1). In our knowledge, 15 acute and 7 chronic cases of epidural hematomas were reported after valve-regulated shunt placement in the literature (2,3,5,(10)(11)(12). Epidural hematoma often becomes symptomatic soon after a neurosurgical operation, whereas diagnosis can be procrastinated in a case of an efficient shunt which helps reduce intraventricular pressure and volume.…”

Section: Discussionmentioning

confidence: 99%

Acute Epidural Hematoma after Ventriculoperitoneal Shunt Insertion: a Case Report

Etemadrezaie

Zabihian

Baharvahdat

et al. 2015

IrJNS

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Background & Importance: Acute epidural hematoma is a very rare complication of ventriculoperitoneal shunt insertion. The insertion of a ventriculoperitoneal shunt can cause sudden decompression of the brain, subsequent to which epidural hematoma occurs due to CSF drainage. To our knowledge, there are only a few cases of acute epidural hematoma in the literature which required acute evacuation. Case Presentation:In this report, we present a case of epidural hematoma close to ventriculoperitoneral shunt insertion site in a 30-year-old man after failure of endoscopic surgery for opening of the wall of a suprasellar arachnoid cyst. Secondary to communication between cyst and ventricles and clinical symptoms and sings, the patient underwent the shunt insertion. The patient became comatose two hours following the insertion of the shunt, developing a voluminous right temporo-parietal epidural hematoma that had to be evacuated immediately. Here, we intend to discuss both the pathophysiology and treatment.Conclusion: Development of epidural hematoma after ventriculoperitoneal shunt surgery is a devastating complication. Dehisensce formation between the skull and dura matter, which may be facilitated by lax adhesion between the two, is a common underlying pathology. We recommend a close post-surgical observation for immediate diagnosis and reoperation of this event.

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“…13 EDH complications generally arise within a few hours after the operation, but the time cited in the literature ranges from a few hours to even 3 years after surgery. 16,17 The symptoms arise rapidly in cases of acute EDH; however, if the bleeding is slow, patients can remain asymptomatic, delaying diagnosis and resulting in adverse outcomes. 10 Byrappa et al suggested two reasons for such a delay.…”

Section: Discussionmentioning

confidence: 99%

Epidural hematoma: postoperative complication

et al. 2017

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Epidural hematoma is an indication for emergency neurosurgical intervention. This condition is an extremely rare postoperative complication of ventriculoperitoneal shunt and contralateral decompressive craniectomy. A 22-year-old male patient was admitted to our clinic with headache and a decline in the level of consciousness. We detected a left thalamic astrocytoma and hydrocephalus, which we treated via ventriculoperitoneal shunt surgery and ventricular drainage in emergency conditions. The patient experienced dysphasia on the first postoperative day and we found a right frontoparietal epidural hematoma. We evacuated the hematoma and exchanged the medium pressure valve for a high-pressure valve. The second patient was a 19-year-old male who had been assaulted. His pupils were fixed and dilated and had no reaction to painful stimulus. We detected bilateral frontotemporal skull fractures and right frontotemporoparietal subdural and epidural hematomas. We performed a right decompressive craniectomy and subdural/epidural hematoma evacuation followed by recovery under sedation in the intensive care unit. We performed cranial computed tomography six hours after surgery and found a left temporoparietal epidural hematoma. We performed a left temporoparietal craniotomy and epidural hematoma evacuation. The patient exhibited a higher level of consciousness and increased movement of his extremities. Epidural hematoma is a life-threatening complication encountered in neurosurgery practice. Neurosurgeons should be aware of the possibility of epidural hematoma following ventriculoperitoneal shunt or traumatic brain injury surgery.

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Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

Cited by 7 publications

References 16 publications

Remote Postoperative Epidural Hematoma after Brain Tumor Surgery

Remote Postoperative Epidural Hematoma after Brain Tumor Surgery

Acute Epidural Hematoma after Ventriculoperitoneal Shunt Insertion: a Case Report

Epidural hematoma: postoperative complication

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