Delayed Intracerebral Hemorrhage after Ventriculoperitoneal Shunting
Intracerebral hemorrhage after a ventricular shunting procedure is uncommon. In our series of 900 shunting procedures we have seen 3 moderate sized hemorrhages (3 to 5 cm in size) for an incidence of 0.3%. One of these cases developed the hemorrhage one week after an uneventful ventricular shunting procedure. The patient left the hospital on the 5th postoperative day feeling well. On the 7th postoperative day she developed a headache and had a generalized convulsion. On readmission she was lethargic, with a stiff neck and a mild left hemiparesis. A CT scan and MRI scan revealed a 3–5 cm right frontal intraparenchymal hematoma along the path of the ventricular catheter. A cerebral angiogram was normal. The patient had had no trauma since the shunting procedure. She had no history of bleeding disorder, and hematological tests including platelet count, prothrombin time, partial thromboplastin time, and bleeding time were all within normal limits. The patient fully recovered without operative intervention.