A rare case of large bilateral epidural hematoma following ventriculoperitoneal shunt: a case report with review of literature

Abstract

Epidural hematoma discovered several years after ventriculoperitoneal shunt procedure is a rare complication. It may be associated with ventricular decompression due to unregulated lowering of intra-cranial pressure. This leads to generation of suction force on structures between the cortex and the inner table of the skull resulting in bleeding from tearing of cortical bridging veins. We report a case of a 15-year-old female patient who underwent an uneventful ventriculoperitoneal shunt at the age of 6 months. 14 years later CT scan was done for the complaints of frequent headache that showed 2 large sized lesions that were partially calcified epidural hematomas. After surgical decompression of the larger of the two hematomas, patient’s symptoms improved. We discuss the possible factors responsible for epidural hematoma, its calcification and ways to prevent or minimize such an avoidable complication.