Related Experiment Videos
Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion
1Department of Radiology, Good Samaritan Hospital, Suffern, New York, USA. drbcasey@aol.com
Insights
Delayed bleeding after ventriculoperitoneal (VP) shunt insertion is rare in adults. This study found a 4% incidence of intracerebral hemorrhage following VP shunt placement, emphasizing the importance of a complication-free procedure.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Intracerebral hemorrhage and intraventricular hemorrhage are infrequent complications following ventriculoperitoneal (VP) shunt insertion in adult patients.
- Understanding the incidence of delayed hemorrhage is crucial for patient safety and procedural refinement.
Purpose of the Study:
- To determine the incidence of delayed intracerebral hemorrhage (ICH) or intraventricular hemorrhage (IVH) after ventricular cannulation during VP shunt placement in adults.
Main Methods:
- A retrospective review of 125 adult hydrocephalus patients undergoing VP shunt surgery by a single neurosurgeon over 24 years.
- Postoperative computerized tomography (CT) scans were obtained within 48 hours for all patients.
- Routine neuroradiological follow-up was used to document hemorrhage events.
Main Results:
- The overall rate of delayed intracerebral hematoma or intraventricular hemorrhage after VP shunt placement was found to be 4% in this cohort.
- This incidence was observed in adult patients without pre-existing coagulopathy or occult vascular lesions.
Conclusions:
- The risk of bleeding complications after VP shunt insertion in adults appears low when the procedure is performed without complications.
- Factors such as multiple ventricular attempts, choroid plexus puncture, and improper catheter placement may increase the risk of hemorrhage.
Object:
Bleeding into the brain parenchyma or ventricles is an infrequently reported complication in adults who undergo insertion of a ventriculoperitoneal (VP) shunt. The purpose of this study was to establish the incidence of delayed intracerebral hemorrhage secondary to ventricular cannulation during shunting procedures.
Methods:
Over a 24-year period, in a series of 125 adult patients with hydrocephalus, postoperative computerized tomography scans were obtained in every case within 48 hours of shunt surgery performed by the same neurosurgeon. The rate of delayed intracerebral hematoma or intraventricular hemorrhage after VP shunt placement was documented by routine neuroradiological follow up to be 4%.
Conclusions:
In adult patients with no coagulopathy or occult vascular lesions, the rate of bleeding after VP shunt insertion may be low if the procedure is uncomplicated by multiple attempts at perforation, puncture of the choroid plexus, or improper placement of the tubing within the parenchyma of the brain.