• Liemei Guo, Xu Chen, Bin Yu, Lin Shen, and Xiaohua Zhang.
• Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, District Pudong, Shanghai, China.
• World Neurosurg. 2017 Nov 1; 107: 160-167.

BackgroundPostoperative delayed intracerebral hemorrhage (DICH) secondary to ventriculoperitoneal (VP) shunt is a rare but severe event. The present study aimed to investigate the incidence and risk factors related to DICH after placement of the VP shunt.MethodsThe clinical data from 532 patients with VP shunt were collected retrospectively. All clinical variables were examined by univariate analysis, and a binary logistic regression analysis was performed to identify the risk factors related to DICH.ResultsDICH occurred in 20 patients, from 3 to 10 days after placement of the VP shunt. Univariate analysis showed significant differences between the patients with DICH and without DICH with respect to age, history of hypertension, history of craniotomy, and features of the first computed tomography (CT) scans after placement of the VP shunt (all P < 0.05). The binary logistic regression analysis showed that age, history of craniotomy, and features of first CT scans after placement of the VP shunt were independent risk factors for DICH (all P < 0.05). The prognosis for patients with DICH was consistent with the hematoma volume and the neurologic status at the time of hospital admission (all P < 0.05).ConclusionsDICH is a rare and potentially severe complication secondary to VP shunt, and a repeat of cranial CT scans after placement of the VP shunt is recommended. Advanced age, craniotomy history, and brain edema around the catheter on the first cranial CT scan after placement of the VP shunt served as independent risk factors for DICH. The patients with DICH with poor neurologic status at the time of hospital admission or large hematoma volume were associated with poor outcome.Copyright © 2017. Published by Elsevier Inc.

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