Severe Traumatic Brain Injury and Ventriculoperitoneal Shunt Challenges: A Case Report

Traumatic brain injury (TBI) is an acquired damage to the brain caused by an external mechanical force and may result in temporary or long-term disability. It is a prevalent condition that highlights the need for increased awareness. Despite advances in the technology used to monitor and guide therapy, it is a difficult and complex disease process to manage. Elevated intracranial pressure (ICP), a complication of neurologic injury, is associated with increased mortality and worse outcomes. Decompressive craniectomy is effective in controlling ICP and is potentially lifesaving in patients who have failed medical therapy. As a long-term treatment, implanting a ventricular-peritoneal (VP) shunt is the typical neurosurgery method for treating hydrocephalus following TBI. Nevertheless, under certain circumstances, VP shunts fail and an interdisciplinary approach is essential to improve patients' outcomes. Herein, we present the case of a previously healthy young male patient who successfully underwent a surgical treatment following TBI. The aim of this case report is to share the knowledge gained at Centro Hospitalar Universitário do São João, in Portugal, regarding complications of VP shunts and how cranioplasty aided in the resolution of the problem.