Neurosurg Focus. Oct 15;15(4):E4. Intracerebral hematoma from aneurysm rupture. Abbed KM(1), Ogilvy CS. Author information: (1)Department of. This recommendation is based upon the potential for patients with ICH to deteriorate from hematoma expansion, elevations in intracranial. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): A.
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Discussion Ventriculoperitoneal shunting VP is one of the most frequently performed procedure in our daily neurosurgical practice.
Disseminated intravascular coagulation as a complication of ventricular catheter placement. The cause of the right occipital intraparenchymal hemorrhage in our patient remains unknown; the mechanism could have been the erosion of a surface or deeper cerebral blood vessel secondary to a close contact between the tubing and the blood vessel, as the cases described by Savitz 18 and Snow A computed tomographic CT scan demonstrated a hemattoma subarachnoid hemorrhage, an interhemispheric hematoma and a intraparenquimatowa acute left temporal subdural hematoma Figure 1.
Negative intracranial pressure hydrocephalus in adults with shunts and its relationship to the production of subdural hematoma.
Hemorragia intracerebral – Wikipédia, a enciclopédia livre
The presumed mechanism is the erosion of a cerebral blood vessel secondary to a close contact with the ventricular catheter; bleeding disorder, vascular malformation, head trauma or brain tumor were excluded in this patient.
We can find some reports of such a complication 9,16,19,23 in which the hemorrhage occurred directly after the operative procedure.
Fukamachi explain on his report in that intracerebral hemorrhage after a ventricular shunting procedure is uncommon, usually occurring soon after surgery 6. Bleeding along the path of the ventricular catheter and into the ventricular system has been reported previously following VP shunt placement 2,6,10,14,19,23 ; it may be caused by puncture of the choroid plexus, repeated attempts at perforation of the ventricles or inadequate placement of the tubing within the parenchyma of the brain.
She was operated on for revision of the VP shunt that proved intraparenquimatoza be obstructed; it hemaatoma removed and we inserted an external ventricular drainage through a right frontal burr hole.
The patient deteriorated progressively, with renal failure and fever toward the multiorganic failure that caused the death of the intraparenqyimatosa on May 25, Udvarhelyi et al 23 reported two cases of intracerebral hematoma after VP shunting among 55 cases of normal pressure hydrocephalus. The subsequent improvement was slight; she remained conscious, with open eyes, but without verbal response and submission. Small amounts of blood are frequently recognized in the ventricle or in the parenchyma along the catheter path intraparenquimxtosabut clinically significant lesions, however, are uncommon 7,15, Surgical Neurology ; Support Radiopaedia and see fewer ads.
The mechanism in these five patients was more likely disruption of a cerebral blood vessel by the catheter; the normal pulsations of the CSF transmitted to the tubing might have caused the catheter to erode through a blood vessel with subsequent intracerebral hemorrhage. Intracerebral hemorrhage remote from the site of the initial neurosurgical procedure. The Getafe Universitary Hospital. Complications of cerebrospinal fluid CSF ventricular shunting have been reported 19,23 a lot of years ago, such as infections, shunt malfunction, subdural hematomas, seizures, migrating catheter, kinked tubing.
Neurological Surgery ; Report of two cases. She was intrapaernquimatosa because of transient loss of conciousness for several minutes following a sudden headache in the morning. Delayed intracerebral hemorrhage after ventriculoperitoneal shunting.
Sayers 19 reported six cases of intracerebral hematoma among shunted cases. We present another case of delayed intracerebral hemorrhage after a ventriculoperitoneal VP shunting procedure.
Cerebral damage following ventricular shunt for infantile hydrocephalus evaluated by computed tomography.
Mascalchi 14 presented in the case of a patient with an extensive intraparenchymal hemorrhage far from the catheter of the VP shunt 12, Post-traumatic petechial and massive intracerebral hemorrhage. Because of the absence of improvement and no decreased ventricular size CT scan performed after 24 hours Figure 4the valve was reprogrammed, this time at 80 mmH 2 O; after it, the patient improved in attention and verbal response.
Ventriculoperitoneal shunting VP is one of the most frequently performed procedure in our daily neurosurgical practice. Case report and literature review. Intraparehquimatosa 12 Case An intracerebral hemorrhageor intraparenchymal cerebral hemorrhageis a subset of an intracranial hemorrhage.
Diagnosis and treatment of diffuse intravascular coagulation following cerebral trauma. Bleeding disorder, tumor, occult vascular malformation or head trauma were not the cause of this event as clinical examination, laboratory tests and radiological studies determined. CT scan performed fifteen days after the clipping of the aneurysm. Shunt implantation reducing the incidence of shunt infection.
A CT scan performed 15 days after the operation revealed marked ventricular dilatation compared with previous imaging study performed on admission Figure 3. The patient was not operated on immediately because her clinical evolution was uematoma favourable. The conventional cerebral angiography was not completed because of the appereance of left hemiparesis; so a CT angiogram was performed revealing a right pericallosal artery aneurysm Figure 2 which was supposed to be the cause of the bleeding.
Introduction Complications of cerebrospinal fluid CSF ventricular shunting have been reported 19,23 a lot of years ago, such as infections, shunt malfunction, subdural hematomas, seizures, migrating catheter, kinked tubing.
Intratumoral hemorrhage after a ventriculoperitoneal shunting procedure.
Histologic studies of the brain following head trauma. Fukamachi et al performed CT scans on patients within the first week intraparfnquimatosa ventricular shunting procedures 6 and found that ten of them had small intracerebral hematomas 3 cm maximal diameter ; they didn’t offer any explanation for the one moderate-sized hematoma in their series. Edit article Share article View revision history. On the other hand, intratumoral hemorrhage has been described following ventricular cannulation 24,25, Postoperative CT hematomz performed 24 hours following ventriculoperitoneal shunt insertion that showed no decreased ventricular size compared with the previous imaging study.
Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion. ICH on warfarin Case 1: Here we report intrapaenquimatosa case of this unusual complication, review the previous literature about cerebral hemorrhagic complications after intraparenquimtaosa shunting procedures and discuss the supposed causative factors and mechanisms involved in this infrequent event. Delayed intracerebral hemorrhage after CSF shunt for communicating “normal-pressure” hydrocephalus.
Loading Stack – 0 images remaining. Journal of Neurosurgery ; 3: The new CT scan Figure 5 revealed a right occipital intraparenchymal hematoma, around the ventricular catheter, with opening to the ventricular system and ventricular size without changes.