[Early epidural hematoma after CSF shunt for obstructive hydrocephalus].
We present the first case of early epidural hematoma after CSF shunt probably caused by defective material. A 26-year-old man was treated for obstructive hydrocephalus associated with a tonsillar herniation, revealed by headaches and papillary edema. Ventriculoperitoneal shunt was preferred to endoscopic ventriculostomy. Three hours after the operation, the patient fell into a coma, developing a voluminous bifrontal epidural hematoma that was evacuated immediately. The patient completely recovered neurologically. One month later, to treat persistent hydrocephalus, endoscopic ventriculostomy was performed without incident. Then the shunt was removed and an opening threshold close to zero was discovered. Distant MRI showed a reduction in ventricular size, normalization of the tonsils' position and a tumor of the tectal plate. To our knowledge, this is the only case of early epidural hematoma after ventriculoperitoneal shunt. We discuss the choice of treatments for obstructive hydrocephalus and its risks and complications.
Service de neurochirurgie, groupe hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
D
D
Chauvet
J-P
JP
Sichez
A-L
AL
Boch
D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D004677:Encephalocele / Q000209:etiology / Q000473:pathology; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006849:Hydrocephalus / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome