Intracranial thrombosis after ventriculoperitoneal shunting

Childs Nerv Syst. 2022 Jun;38(6):1205-1208. doi: 10.1007/s00381-021-05319-0. Epub 2021 Aug 14.

Abstract

We report a case of intracranial thrombosis (IT) after ventriculoperitoneal shunting (VPS). We reviewed the literature to highlight the importance of considering the possibility of cerebral venous thrombosis following VPS, even though it is a rarely reported complication. A 14-year-old boy underwent distal catheter replacement due to its short size that was detected during a routine consultation. Five days postoperatively, he experienced nausea, vomiting, seizures, and headache. Although a diagnosis of meningitis was considered, diagnosis of IT was eventually confirmed through computed tomography venography and gadolinium magnetic angioresonance. The patient subsequently underwent anticoagulant therapy, which led to complete resolution of symptoms. In this report, we suggest a possible association between VPS and IT, which is a complication that is not commonly reported. The literature suggests that decreased blood flow due to over-drainage of CSF after VPS causes decreased head pressure, culminating in venous stasis and consequent thrombosis. In addition, the literature describes associations between IT and lumbar puncture (LP); therefore, it is important to consider the possibility of IT following these procedures.

Keywords: Complications; Heparin; Intracranial thrombosis; Ventriculoperitoneal shunt.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Anticoagulants
  • Cranial Sinuses
  • Humans
  • Intracranial Thrombosis* / diagnostic imaging
  • Intracranial Thrombosis* / etiology
  • Male
  • Tomography, X-Ray Computed
  • Ventriculoperitoneal Shunt* / adverse effects
  • Ventriculoperitoneal Shunt* / methods

Substances

  • Anticoagulants