Sequential Multiple Epidural Hematomas Following Ventriculoperitoneal Shunt

ABSTRACT

For the treatment of a hydrocephalic patient, the ventriculoperitoneal shunt operation has been widely accepted, and although extra-axial hematomas are a well-known complication of ventricular shunting, epidural hematomas are uncommon in this setting. We report an unusual case of sequential multiple epidural hematomas in a 24-year-old man with hydrocephalus treated by ventriculoperitoneal shunt. For the evacuation of hematomas which had developed at different sites, the patient required three craniotomies. Possible etiologies have been examined, and the mechanism for the development of epidural hematoma after shunt operation is thought to be due to the rapid lowering of intracranial pressure and separation of the dura from the skull, causing oozing from small dural vessels ; to avoid this complication, the sudden perioperative lowering of intracranial pressure should be prevented. In addition, the literature is reviewed and discussed.