Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Cerebral Venous Thrombosis Complicated by Hemorrhagic Infarction Secondary to Ventriculoperitoneal Shunting

  • Son, Won-Soo (Department of Neurosurgery, Kyungpook National University Hospital) ;
  • Park, Jae-chan (Department of Neurosurgery, Kyungpook National University Hospital)
  • Received : 2009.11.11
  • Accepted : 2010.08.09
  • Published : 2010.10.28
Download PDF
⟨ Previous Next ⟩

Abstract

While a delayed intracerebral hemorrhage at the site of a ventricular catheter has occasionally been reported in literature, a delayed hemorrhage caused by venous infarction secondary to ventriculoperitoneal shunting has not been previously reported. In the present case, a 68-year-old woman underwent ventriculoperitoneal shunting through a frontal burr hole, and developed a hemorrhagic transformation of venous infarction on the second postoperative day. This massive venous infarction was caused by bipolar coagulation and occlusion of a large paramedian cortical vein in association with atresia of the rostral superior sagittal sinus. Thus, to eliminate the risk of postoperative venous infarction, technical precautions to avoid damaging surface vessels in a burr hole are required under loupe magnification in ventriculoperitoneal shunting.

Keywords

References

  1. Alcazar L, Alfaro R, Tamarit M, Gomez-Angulo JC, Ortega JM, Aragones P, et al, : Delayed intracerebral hemorrhage after ventriculoperitoneal shunt insertion, Case report and literature review, Neurocirugia (Astur) 18 : 128-133,2007 https://doi.org/10.1016/S1130-1473(07)70299-3
  2. Arquizan C, Meder J, Mas J : Brain venous thrombosis syndrome, in Bogousslavsky J, Caplan L (eds) : Stroke syndromes, ed 2, Cambridge, Cambridge University Press, 2001, pp 626-650
  3. Caplan LR: Cerebral venous thrombosis, in Caplan LR (ed) : Caplan's stroke : a clinical approach, ed 3, Boston, Butterworth-Heinemann, 2000, pp 463-487
  4. Fukamachi A, Koizumi H, Nukui H : Postoperative intracerebral hemorrhages : a survey of computed tomographic findings after 1074 intracranial operations, Surg Neurol 23 : 575-580, 1985 https://doi.org/10.1016/0090-3019(85)90006-0
  5. Kaplan HA, Browder J : Atresia of the rostral superior sagittal sinus : substitute parasagittal venous channels. J Neurosurg 38 : 602-607, 1973 https://doi.org/10.3171/jns.1973.38.5.0602
  6. Kubokura T, Nishimura T, Koyama S, Sanno N, Tsubone K: [Delayed intracerebral hemorrhage following VP shunt operation]. No Shinkei Geka 16 : 523-527, 1988
  7. Mapstone TB, Ratcheson RA: Technique of ventricular puncture, in Wilkins RH, Rengachary SS (eds) : Neurosurgery, ed 2. New York, McGraw-Hill Companies, Inc., 1996, pp179-183
  8. Matsumura A, Shinohara A, Munekata K, Malti Y : Delayed intracerebral hemorrhage after ventriculoperitoneal shunt. Surg Neurol 24 : 503-506, 1985 https://doi.org/10.1016/0090-3019(85)90264-2
  9. McComb JG : Techniques for CSF diversion, in Scott RM (ed) : Hydrocephalus, Baltimore, Williams & Wilkins, 1990, pp 47-65
  10. Osborn AG : The cerebral veins, in Osborn AG (ed) : Diagnostic cerebral angiography, ed 2. Philadelphia, Lippincott Williams & Wilkins, 1999, pp 217-237
  11. Pang D, Grabb PA : Accurate placement of coronal ventricular catheter using stereotactic coordinate-guided free-hand passage. Technical note. J Neurosurg 80: 750-755,1994 https://doi.org/10.3171/jns.1994.80.4.0750
  12. Park J, Hamm IS : Anterior interhemispheric approach for distal anterior cerebral artery aneurysm surgery : preoperative analysis of the venous anatomy can help to avoid venous infarction. Acta Neurochir (Wien) 146: 973-977; discussion 977, 2004
  13. Ruge JR, Melone DG : Cerebrospinal fluid diversion procedures, in Apuzzo MLJ (ed) : Brain surgery: complication avoidance and management. New York, Churchill Livingstone Inc., 1993, pp 1463-1494
  14. Sainte-Rose C : Hydrocephalus in childhood, in Youmans JR (ed) : Neurological surgery, ed 2. Philadelphia, W.B. Saunders Company, 1996, pp 890-926
  15. Savitz MH, Bobroff LM : Low incidence of delayed hemorrhage secondary to ventriculoperitoneal shunt insertion, J Neurosurg 91 : 32-34, 1999 https://doi.org/10.3171/jns.1999.91.1.0032
  16. Sindou M, Auque J : The intracranial venous system as a neurosurgeon's perspective, in Cohadon F (ed) : Advances and technical standards in neurosurgery, Wien New York: Springer, 2000, vol 26. pp131-216
  17. Snow RB, Zimmerman RD, Devinsky O: Delayed intracerebral hemorrhage after ventriculoperitoneal shunting. Neurosurgery 19 : 305-307, 1986 https://doi.org/10.1227/00006123-198608000-00026
  18. Widjaja E, Griffiths PD : Intracranial MR venography in children: normal anatomy and variations. AJNR Am J Neuroradiol 25 : 1557-1562,2004

Cited by

  1. Delayed Intraventricular Hemorrhage following a Ventriculoperitoneal Shunt Placement: Exploring the Surgical Anatomy of a Rare Complication vol.2017, pp.None, 2017, https://doi.org/10.1155/2017/3953248