Musali Siddartha Reddy, Manne Srikrishnaditya, Beniwal Hemant K, Butkuri Nagarjuna, Gollapudi Prakash Rao, Nandigama Pratap Kumar
Department Of Neurosurgery, Gandhi Medical College and Hospital, Secunderabad, Telangana, India.
J Neurosci Rural Pract. 2019 Jul;10(3):533-536. doi: 10.1055/s-0039-1697769. Epub 2019 Oct 7.
Ventriculoperitoneal (VP) shunt is a frequently performed operation to achieve cerebrospinal fluid (CSF) diversion but is associated with many complications. Postoperative delayed intracerebral hemorrhage is a kind of rare but catastrophic complication of a VP shunt which questions the survival of a seemingly recovered patient. Here, we present one such case where the patient presented to casualty in altered sensorium and with a history of vomiting. On examination, the Glasgow Coma Scale (GCS) score was E2V1M3; pupils were middilated but reactive. Computerized tomography of the brain showed ventriculomegaly and hydrocephalus, and an emergency VP shunt was done. There was an initial phase of good recovery followed by sudden loss consciousness, vomiting, and a fall in the GCS scores on postoperative day 7. Computed tomography showed an intracerebral hematoma along the shunt track and an intraventricular bleed. The presumed cause for this occurrence is a deranged coagulation profile.
脑室腹腔（VP）分流术是一种常用于实现脑脊液（CSF）分流的手术，但会引发多种并发症。术后迟发性脑出血是VP分流术一种罕见却灾难性的并发症，这对看似已康复的患者的生存构成了威胁。在此，我们呈现这样一个病例：患者因意识改变和呕吐史被送往急诊室。检查时，格拉斯哥昏迷量表（GCS）评分为E2V1M3；瞳孔中等散大但有反应。脑部计算机断层扫描显示脑室扩大和脑积水，遂进行了紧急VP分流术。术后初期恢复良好，但在术后第7天突然出现意识丧失、呕吐，GCS评分下降。计算机断层扫描显示沿分流道有脑内血肿及脑室内出血。推测这种情况的发生原因是凝血功能紊乱。
