Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0036-1594245
Remote Cerebellar Hemorrhage Following Lumboperitoneal Shunt Insertion: A Rare Case Report
Publication History
15 June 2016
13 October 2016
Publication Date:
01 December 2016 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00028781/201604/lookinside/thumbnails/10-1055-s-0036-1594245_1600069cr-1.jpg)
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.
-
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
- 2 Brazis PW. Clinical review: the surgical treatment of idiopathic pseudotumour cerebri (idiopathic intracranial hypertension). Cephalalgia 2008; 28 (12) 1361-1373
- 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
- 4 Dykhuizen MJ, Hall J. Cerebral venous sinus system and stenting in pseudotumor cerebri. Curr Opin Ophthalmol 2011; 22 (06) 458-462
- 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
- 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
- 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
- 8 Thambisetty M, Lavin PJ, Newman NJ, Biousse V. Fulminant idiopathic intracranial hypertension. Neurology 2007; 68 (03) 229-232
- 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
- 10 Rosenberg ML, Corbett JJ, Smith C. , et al. Cerebrospinal fluid diversion procedures in pseudotumor cerebri. Neurology 1993; 43 (06) 1071-1072
- 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
- 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
- 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
- 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
- 15 Friedman JA, Piepgras DG, Duke DA. , et al. Remote cerebellar hemorrhage after supratentorial surgery. Neurosurgery 2001; 49 (06) 1327-1340
- 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
- 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