title: Bilateral extradural haematoma after acute ventricular over-drainage.
abstract: BACKGROUND
  Ventricular over-drainage is a common complication of dysfunctional ventriculoperitoneal devices. Subdural haematomas are usually the most common lesions associated with that complication. Such lesions may arise after ventricular collapse and bridging veins disruption that follows over-drainage, thus contributing to distortion of brain parenchyma, increased intracranial hypertension and neurological decline. More rarely, extradural haematomas may also be observed after ventricular shunt hyperfunction and may result in rapid neurological decline unless a surgical procedure can be promptly performed.
  
  
  METHODS
  This study reports the case of a 38-old-woman who presented supratentorial hydrocephalus and developed bilateral extradural haematomas after the placement of a ventricular shunt device. Both haematomas were surgically approached and the dysfunctional shunt device was replaced.
  
  
  CONCLUSIONS
  Extradural haematomas may develop precociously after ventricular over-drainage. Surgical treatment is mandatory and must include not only the evacuation of haematoma, but also the replacement of dysfunctional shunt to prevent further recurrence. The pathophysiology of extradural haematomas consequent of ventricular over-drainage and the possible use of a programmable valve to prevent these lesions are briefly discussed.
authors.affiliation: Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Cidade Universitária, Rio de Janeiro, RJ, Brazil. louzada@rocketmail.com
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Louzada
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Requejo
authors.forename: Marcelo Viana
authors.initials: MV
authors.lastname: Barroso
authors.forename: Rafael Pereira
authors.initials: RP
authors.lastname: Vaitsman
authors.forename: Alexandre Légora
authors.initials: AL
authors.lastname: Machado
authors.forename: Mauro Sérgio
authors.initials: MS
authors.lastname: Paiva
authors.forename: José Massoud
authors.initials: JM
authors.lastname: Salame
mesh_terms: D000328:Adult; D020878:Device Removal; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D046648:Hematoma, Subdural, Intracranial / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*