title: Fatal intratumoral hemorrhage in posterior fossa tumors following ventriculoperitoneal shunt.
abstract: We report on two patients with rare major intratumoral hemorrhage following ventriculoperitoneal shunt in posterior fossa tumors. A 28-year-old woman with a midline posterior fossa lesion, whose imaging features suggested a fourth ventricular ependymoma with obstructive hydrocephalus, was subjected to a right ventriculoperitoneal shunt. Her consciousness deteriorated, and she experienced massive intratumoral hemorrhage and later died. An eight-year-old girl presented with raised intracranial pressure and ataxia caused by vermian astrocytoma with obstructive hydrocephalus. She also developed a massive tumor bleed following a ventriculoperitoneal shunt and was subjected to emergency decompression of the tumor with the bleeding. She remained vegetative at discharge and died 18 months later. Intratumoral hemorrhage is a rare but important cause of morbidity and mortality in patients with posterior fossa tumors who undergo ventriculoperitoneal shunt.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and NeuroSciences (NIMHANS), Hosur Road, Bangalore 560 029, India.
authors.forename: R
authors.initials: R
authors.lastname: Santhanam
authors.forename: Anandh
authors.initials: A
authors.lastname: Balasubramaniam
authors.forename: B A
authors.initials: BA
authors.lastname: Chandramouli
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000601:surgery*; D002648:Child; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015192:Infratentorial Neoplasms / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*