Matsumura A, Shinohara A, Munekata K, Maki Y
Surg Neurol. 1985 Nov;24(5):503-6. doi: 10.1016/0090-3019(85)90264-2.
A serious intracerebral hemorrhage occurred as a result of a measurement for grip power performed on the 7th postoperative day of a ventriculoperitoneal shunt. This type of delayed intracerebral hemorrhage after the placement of a ventriculoperitoneal shunt has not been described in the literature. The increased intracranial venous pressure produced by Valsalva's effect induced this complication, which is also considered to be the same mechanism as traumatic delayed intracerebral hemorrhage.