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CC BY 4.0 · Surg J (N Y) 2016; 02(04): e139-e142
DOI: 10.1055/s-0036-1594245
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Remote Cerebellar Hemorrhage Following Lumboperitoneal Shunt Insertion: A Rare Case Report

Fatih Ayvalık
1   Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
,
Rafet Ozay
1   Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
,
Erhan Turkoglu
1   Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
,
Mehmet Serdar Balkan
1   Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
,
Zeki Şekerci
1   Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

15 June 2016

13 October 2016

Publication Date:
01 December 2016 (online)

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Abstract

Idiopathic intracranial hypertension is characterized by high intracranial pressure without hydrocephalus or intracranial mass. Surgical treatment includes optic nerve fenestration and insertion of ventriculoperitoneal and lumboperitoneal (LP) shunts. For decreasing intracranial pressure, cerebrospinal fluid (CSF) LP shunt is widely used for the surgical management; it also carries complications such as shunt migration, venous sinus thrombosis, subarachnoid hemorrhage, and subdural and intracerebral hematoma. A 52-year-old man was admitted to the neurosurgery clinic with severe headache, retro-orbital pain, and blurred vision. Lumbar puncture demonstrated that the CSF opening pressure was 32 cm H2O. A nonprogrammable LP shunt with two distal slit valves was inserted. Shortly after the surgery, his condition deteriorated and he became comatose. Immediate computed tomography scan revealed cerebellar hemorrhage and acute hydrocephalus. Development of remote cerebellar hemorrhage following LP shunt is rare. We discuss this rare event and the applicable literature.

Keywords

cerebellar hemorrhage - complication - lumboperitoneal shunt
 

  • References

  • 1 Biousse V, Bruce BB, Newman NJ. Update on the pathophysiology and management of idiopathic intracranial hypertension. J Neurol Neurosurg Psychiatry 2012; 83 (05) 488-494
    CrossrefPubMedGoogle Scholar
  • 2 Brazis PW. Clinical review: the surgical treatment of idiopathic pseudotumour cerebri (idiopathic intracranial hypertension). Cephalalgia 2008; 28 (12) 1361-1373
    CrossrefPubMedGoogle Scholar
  • 3 Durcan FJ, Corbett JJ, Wall M. The incidence of pseudotumor cerebri. Population studies in Iowa and Louisiana. Arch Neurol 1988; 45 (08) 875-877
    CrossrefPubMedGoogle Scholar
  • 4 Dykhuizen MJ, Hall J. Cerebral venous sinus system and stenting in pseudotumor cerebri. Curr Opin Ophthalmol 2011; 22 (06) 458-462
    CrossrefPubMedGoogle Scholar
  • 5 Wall M, George D. Visual loss in pseudotumor cerebri. Incidence and defects related to visual field strategy. Arch Neurol 1987; 44 (02) 170-175
    CrossrefPubMedGoogle Scholar
  • 6 Corbett JJ, Nerad JA, Tse DT, Anderson RL. Results of optic nerve sheath fenestration for pseudotumor cerebri. The lateral orbitotomy approach. Arch Ophthalmol 1988; 106 (10) 1391-1397
    CrossrefPubMedGoogle Scholar
  • 7 Celebisoy N, Gökçay F, Sirin H, Akyürekli O. Treatment of idiopathic intracranial hypertension: topiramate vs acetazolamide, an open-label study. Acta Neurol Scand 2007; 116 (05) 322-327
    CrossrefPubMedGoogle Scholar
  • 8 Thambisetty M, Lavin PJ, Newman NJ, Biousse V. Fulminant idiopathic intracranial hypertension. Neurology 2007; 68 (03) 229-232
    CrossrefPubMedGoogle Scholar
  • 9 Riffaud L, Moughty C, Henaux PL, Haegelen C, Morandi X. Acquired Chiari I malformation and syringomyelia after valveless lumboperitoneal shunt in infancy. Pediatr Neurosurg 2008; 44 (03) 229-233
    CrossrefPubMedGoogle Scholar
  • 10 Rosenberg ML, Corbett JJ, Smith C. , et al. Cerebrospinal fluid diversion procedures in pseudotumor cerebri. Neurology 1993; 43 (06) 1071-1072
    CrossrefPubMedGoogle Scholar
  • 11 Turkoglu E, Kazanci B, Karavelioglu E, Sanli M, Kazanci B, Sekerci Z. Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report. Turk Neurosurg 2011; 21 (01) 94-96
    PubMedGoogle Scholar
  • 12 Duthel R, Nuti C, Motuo-Fotso MJ, Beauchesne P, Brunon J. [Complications of lumboperitoneal shunts. A retrospective study of a series of 195 patients (214 procedures)]. Neurochirurgie 1996; 42 (02) 83-89 , discussion 89–90
    PubMedGoogle Scholar
  • 13 Suri A, Pandey P, Mehta VS. Subarachnoid hemorrhage and intracereebral hematoma following lumboperitoneal shunt for pseudotumor cerebri: a rare complication. Neurol India 2002; 50 (04) 508-510
    PubMedGoogle Scholar
  • 14 Friedman JA, Ecker RD, Piepgras DG, Duke DA. Cerebellar hemorrhage after spinal surgery: report of two cases and literature review. Neurosurgery 2002; 50 (06) 1361-1363 , discussion 1363–1364
    CrossrefPubMedGoogle Scholar
  • 15 Friedman JA, Piepgras DG, Duke DA. , et al. Remote cerebellar hemorrhage after supratentorial surgery. Neurosurgery 2001; 49 (06) 1327-1340
    CrossrefPubMedGoogle Scholar
  • 16 Bloch J, Regli L. Brain stem and cerebellar dysfunction after lumbar spinal fluid drainage: case report. J Neurol Neurosurg Psychiatry 2003; 74 (07) 992-994
    CrossrefPubMedGoogle Scholar
  • 17 Brockmann MA, Nowak G, Reusche E, Russlies M, Petersen D. Zebra sign: cerebellar bleeding pattern characteristic of cerebrospinal fluid loss. Case report. J Neurosurg 2005; 102 (06) 1159-1162
    CrossrefPubMedGoogle Scholar