Late Acute Spontaneous Giant Epidural Hematoma After Ventriculoperitoneal Shunt Surgery: A Case Report

Introduction: Subdural hematoma is the most common type of hemorrhage as a shunt complication following ventriculoperitoneal shunt procedures. This hemorrhage is caused by rupture of the bridging veins between the dura mater and brain due to a suddenly developing decrease in intracranial pressure. On the other hand, the mechanism of late epidural hemorrhage, a complication of ventriculoperitoneal shunt, could not been clarified very clearly. Case Presentation: A 7-year old female patient had been operated for meningomyelocele after birth. One month later, ventriculoperitoneal shunt had been placed. She presented to the emergency department with nausea, vomiting, blurred consciousness and loss of strength (2/5) in the left upper extremity 4 years after the revision. She had a Glasgow Coma Scale score of 10. Brain computed tomography revealed a giant epidural hematoma in the right hemisphere. Conclusion: Brain computed tomography should be obtained in the postoperative period and anti-siphon device should be used when placing ventriculoperitoneal shunt. In addition, we argue that use of moderate-high pressure shunt is not definitely effective in preventing development of epidural hemorrhage.