Controlateral epidural hematoma after VP shunt: A case report

Area of Science:

• Neurosurgery
• Pediatric Neurology

Background:

• Cerebrospinal fluid over-drainage is a known complication of ventriculoperitoneal (VP) shunts.
• Hemorrhagic complications like subdural hematomas are more common than epidural hematomas after VP shunt procedures.
• Epidural hematomas, though rare, can cause rapid neurological decline and necessitate urgent surgical evacuation.

Observation:

• A 5-year-old boy with congenital hydrocephalus developed a large contralateral epidural hematoma after shunt revision.
• The patient experienced sudden neurological decline necessitating surgical intervention.

Findings:

• The case highlights the extreme rarity of contralateral epidural hematomas following ventriculoperitoneal shunt procedures.
• Surgical evacuation of the epidural hematoma resulted in a good postoperative outcome.

Implications:

• This case underscores the importance of considering rare complications like contralateral epidural hematomas in shunt management.
• Programmable valves may offer a potential strategy to mitigate risks associated with cerebrospinal fluid over-drainage and subsequent hemorrhage.