Characteristics of delayed intracerebral hemorrhage after ventriculoperitoneal shunt insertion
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Weiyi Gong1,*, Li Xu2,*, Peng Yang3,*, Zhengquan Yu4, Zhong Wang4, Gang Chen4, Shiming Zhang4 and Jiang Wu4
1Department of Neurosurgery, The First People’s Hospital of Kunshan, Suzhou, Jiangsu Province, 215300, China
2Department of Intensive Care Unit, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215006, China
3Department of Emergency, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215006, China
4Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215006, China
*These authors have contributed equally to this work
Gang Chen, email: firstname.lastname@example.org
Jiang Wu, email: email@example.com
Shiming Zhang, email: firstname.lastname@example.org
Keywords: delayed intracerebral hemorrhage, hydrocephalus, ventriculoperitoneal shunt
Received: December 30, 2016 Accepted: March 21, 2017 Published: April 27, 2017
Background: Delayed intracerebral hemorrhage after ventriculoperitoneal (VP) shunt insertion is rare and has not been well investigated previously. Its characteristics is still unknown.
Objective: We reported 12 patients with delayed intracerebral hemorrhage after VP shunt to investigate the potential risk factors and the outcome.
Results: 12 patients (1.59%) of all the 754 hydrocephalus had delayed intracerebral hemorrhage after VP shunt insertion. 4 patients were women and 8 patients were men, ranging in age from 50 to 76 years. The delayed cerebral hemorrhage from day 3 to day 7 post operation was diagnosed by repeated CT. The delayed intracerebral hemorrhage was significantly related to age, prior craniotomy operation history and manipulation of valve system (3–7 days). Neither gender sexuality nor potential risk factors for postoperative hemorrhage (including anticoagulation/antiplatelet status, liver disease, diabetes, hypertension), time of shunt attempt affected the happen of delayed intracerebral hemorrhage.
Materials and Methods: The clinical characteristics including sex, age, anticoagulation/antiplatelet status, liver disease, diabetes, hypertension, craniotomy operation history, manipulation of valve system and time of shunt attempt of 754 patients who were surgically treated of VP shunt at the first affiliated hospital of Soochow University between 2007 and 2013 were reviewed retrospectively. The potential risk factors of the delayed intracerebral hemorrhage were statistically analyzed.
Conclusions: This study summarizes the presentation and outcome of a series of 12 patients with delayed intracerebral hemorrhage after VP shunt. Age ≥ 60 years, prior craniotomy operation and manipulation of the valve system are statistically significant to the delayed hematoma secondary to VP shunt.
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