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[Pneumocephalus caused by failed ventricular tap: case report].

Toshinari Meguro1, Kinya Terada, Nobuyuki Hirotsune

  • 1Department of Neurological Surgery, Hiroshima City Hospital, Japan.

No Shinkei Geka. Neurological Surgery
|June 15, 2005
PubMed
Summary

A rare complication of pneumocephalus (brain air) occurred after a failed ventricular tap procedure in a hydrocephalus patient. This case highlights the potential for severe neurological deficits following even basic neurosurgical interventions.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Complications

Background:

  • Normal pressure hydrocephalus (NPH) is a condition often resulting from subarachnoid hemorrhage.
  • Ventriculo-peritoneal shunts are a common treatment for NPH.
  • Ventricular tap is a critical step in shunt placement.

Observation:

  • A 79-year-old woman with NPH underwent a ventriculo-peritoneal shunt procedure.
  • The initial two attempts at ventricular tap failed.
  • The third ventricular tap was successful, but the patient developed hemiparesis post-operatively.

Findings:

  • Computed tomography revealed air in the brain along the path of the failed ventricular taps.
  • The air accumulation correlated with the patient's neurological deterioration, progressing to paralysis.

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  • This indicates pneumocephalus as a direct consequence of the failed ventricular tap attempts.

    • Implications:

    • Failed ventricular taps, though uncommon, can lead to severe neurological complications like pneumocephalus.
    • Minimizing attempts during ventricular catheterization is crucial to prevent such adverse events.
    • Neurosurgeons must be vigilant for rare complications associated with standard procedures.