title: Delayed Intracerebral Hemorrhage Secondary to Ventriculoperitoneal Shunt: A Case Report and Literature Review.
abstract: The ventriculoperitoneal (VP) shunt is a routine procedure for cerebrospinal fluid (CSF) diversion, and is associated with many complications. A delayed hemorrhage after the VP shunt surgery, however, is quite rare. In this study, we report a case involving late-onset hemorrhage. The 67-year-old male patient with a history of head trauma and brain surgery underwent a VP shunt placement for hydrocephalus. The surgery course was uneventful and no bleeding was revealed in the first computed tomographic (CT) scan after the procedure. However, a massive intraparenchymal and intraventricular hemorrhage occurred 8 h following adjustment of the valve system on the 8th day after surgery.Erosion of the vasculature by catheter cannulation and a sudden reduction of CSF pressure after downregulation of the valve could be one of the possible causes of the intracerebral hemorrhage (ICH).
authors.affiliation: From the Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ma
authors.forename: Yi-Li
authors.initials: YL
authors.lastname: Chen
authors.forename: Shu-Xu
authors.initials: SX
authors.lastname: Yang
authors.forename: Yi-Rong
authors.initials: YR
authors.lastname: Wang
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D017809:Fatal Outcome; D015600:Glasgow Coma Scale; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D008297:Male; D010166:Palliative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects / Q000379:methods