title: Cerebellar hemorrhage after multiple manual pumping tests of a ventriculoperitoneal shunt: a case report.
abstract: A manual pumping test is commonly used to verify the patency of a ventriculoperitoneal (V-P) shunt. Complications occurring after manual pumping of the reservoir are rare. Here, we report a 73-year-old male hydrocephalic patient who had undergone uneventful V-P shunt surgery 9 years ago. He developed a cerebellar hemorrhage after repetitive pressing of the shunt reservoir. The clinical manifestations, characteristic radiologic images, treatment outcome, and possible mechanisms of this late complication are presented. The risk of massive cerebrospinal fluid overdrainage after repetitive manual pumping of the V-P shunt reservoir, which can contribute to the formation of a cerebellar hemorrhage, warrants special attention and hydrocephalic patients and their caregivers should be informed and educated about this potential complication.
authors.affiliation: Division of Neurosurgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Huang
authors.forename: Yu-Chang
authors.initials: YC
authors.lastname: Hung
authors.forename: Shih-Huang
authors.initials: SH
authors.lastname: Tai
authors.forename: E-Jian
authors.initials: EJ
authors.lastname: Lee
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D011859:Radiography; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*