Chronic Subdural Hematoma after Lumboperitoneal Shunt Replacement: A Case Report From Iran

Hossein Ghalaenovi, Maziar Azar, Hessam Rahatlou, Shahrzad Astaraki
2016 Iranian Journal of Neurosurgery  
and Importance: Lumboperitoneal shunts are commonly used to treat several conditions, but their use can result in significant complications. We discussed a complication of these shunts that has not been reported in the literature to date. Case Presentation: An obese, 41-year-old woman admitted to Rasool Akram Hospital complained of a severe headache and blurred vision. The physical examination indicated that she had papilledema, and a lumbar puncture demonstrating cerebrospinal fluid opening
more » ... al fluid opening pressure of 33 cm of H 2 O. Pseudotumor cerebri was diagnosed, and the patient underwent surgery to insert a lumboperitoneal shunt. She suffered from severe headaches and nausea during the post-operative period. The post-operative syndrome was misdiagnosed as shunt-induced cerebellar tonsillar ptosis; however, further evaluation indicated that intracranial chronic subdural hematoma, a very rare complication subsequent to lumboperitoneal shunting, was the cause of the post-operative syndrome. Subdural hematoma was evacuated, and her symptoms disappeared thereafter. Conclusion: Persistent symptoms, such as headache, nausea, and vomiting, after placement of a lumboperitoneal shunt should be taken serious, and imaging, such as a CT of the brain, should be done to rule out subdural hematoma. Abstract literature did not provide any previous report of subacute or chronic subdural hematoma subsequent to placement of LP shunt in patients with BIH. Persistent symptoms, such as headache, nausea, and vomiting, after placement of a LP shunt should not be taken for granted. CT imaging is essential to rule out subdural hematoma.
doi:10.18869/acadpub.irjns.2.3.22 fatcat:xsi6mylrqfa2pmybtprsbe52cq