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Bilateral extradural haematoma after acute ventricular over-drainage

2011; Taylor & Francis; Volume: 26; Issue: 1 Linguagem: Inglês

10.3109/02699052.2011.635356

1362-301X

Paulo Roberto Louzada, Paulo Roberto Requejo, Marcelo Viana Barroso, Rafael Pereira Vaitsman, Alexandre Légora Machado, Mauro Sérgio Paiva, José Massoud Salame,

Cerebrospinal fluid and hydrocephalus

Ventricular over-drainage is a common complication of dysfunctional ventriculoperitoneal devices. Subdural haematomas are usually the most common lesions associated with that complication. Such lesions may arise after ventricular collapse and bridging veins disruption that follows over-drainage, thus contributing to distortion of brain parenchyma, increased intracranial hypertension and neurological decline. More rarely, extradural haematomas may also be observed after ventricular shunt hyperfunction and may result in rapid neurological decline unless a surgical procedure can be promptly performed.This study reports the case of a 38-old-woman who presented supratentorial hydrocephalus and developed bilateral extradural haematomas after the placement of a ventricular shunt device. Both haematomas were surgically approached and the dysfunctional shunt device was replaced.Extradural haematomas may develop precociously after ventricular over-drainage. Surgical treatment is mandatory and must include not only the evacuation of haematoma, but also the replacement of dysfunctional shunt to prevent further recurrence. The pathophysiology of extradural haematomas consequent of ventricular over-drainage and the possible use of a programmable valve to prevent these lesions are briefly discussed.