• Neurol. Med. Chir. (Tokyo) · Jan 2010

    Case Reports

    Intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion--four case reports.

    • Kouichi Misaki, Naoyuki Uchiyama, Yutaka Hayashi, and Jun-ichiro Hamada.
    • Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. misaki@ns.m.kanazawa-u.ac.jp
    • Neurol. Med. Chir. (Tokyo). 2010 Jan 1;50(1):76-9.

    AbstractFour patients presented with intracerebral hemorrhage secondary to ventriculoperitoneal (VP) shunt insertion. VP shunt insertion was performed for idiopathic normal-pressure hydrocephalus (Case 1), hydrocephalus after cerebellar hemorrhage (Case 2), and subarachnoid hemorrhage followed by meningitis (Cases 3 and 4). Cerebral hemorrhage was confirmed 4 hours (Case 1), 2 days (Case 2), 7 days (Case 3), and 13 days (Case 4) after the operation. Cases 1 and 2 required intraoperative hemostasis for bleeding from the cortical vein. The 7 previous and our 4 patients were divided according to early (within 2 days after shunt placement, n = 6, Group 1) and delayed (5-13 days post-shunting, n = 5, Group 2) hemorrhage. Bleeding was attributable to venous occlusion due to intraoperative manipulation in Group 1, and to the vulnerability of brain tissue induced by a primary brain disease in Group 2.

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