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Updated: Feb 25, 2026
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Published on: October 14, 2022
Delayed Intracerebral Hemorrhage Secondary to Ventriculoperitoneal Shunt: A Retrospective Study
Liemei Guo1, Xu Chen2, Bin Yu2
1Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, District Pudong, Shanghai, China.
Insights
Delayed intracerebral hemorrhage (DICH) after ventriculoperitoneal (VP) shunt placement is rare but serious. Advanced age, prior craniotomy, and CT scan findings are key risk factors for DICH.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Delayed intracerebral hemorrhage (DICH) following ventriculoperitoneal (VP) shunt placement is a rare but severe complication.
- Understanding the incidence and risk factors for DICH is crucial for patient safety.
Purpose of the Study:
- To investigate the incidence of DICH after VP shunt placement.
- To identify independent risk factors associated with DICH.
Main Methods:
- Retrospective analysis of clinical data from 532 patients who underwent VP shunt placement.
- Univariate and binary logistic regression analyses were performed to identify risk factors.
Main Results:
- DICH occurred in 20 patients (3-10 days post-shunt placement).
- Independent risk factors for DICH included advanced age, history of craniotomy, and specific findings on initial CT scans.
- Hematoma volume and initial neurologic status correlated with patient prognosis.
Conclusions:
- DICH is a rare but significant complication of VP shunts.
- Advanced age, prior craniotomy, and early CT findings of periventricular edema are independent risk factors.
- Repeat cranial CT scans are recommended post-VP shunt placement; poor neurologic status and large hematoma volume predict adverse outcomes.
Background:
Postoperative 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.
Methods:
The 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.
Results:
DICH 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).
Conclusions:
DICH 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.
