Journal of Korean Society of Geriatric Neurosurgery 2012;8(2):111-113.
Published online December 30, 2012.
Treatment of Subdural Hematoma after Ventriculoperitoneal Shunt in Patients with Idiopathic Normal Pressure Hydrocephalus
Min Jae Cho , Chun Kee Chung
Department of Neurosurgery, Seoul National University Hospital, Neuroscience Research Institute, Seoul National University Medical Research Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea
Abstract
Objective
Subdural hematoma (SDH) following ventriculoperitoneal shunt (VPS) for idiopathic normal pressure hydrocephalus (iNPH) is a rare complication. To report our experience on the management of SDH after VPS in patients with iNPH.
Methods
A retrospective review of clinical records of iNPH patients who were diagnosed as subdural hemorrhage after shunt operation from January 2003 to December 2012 was performed.
Results
Forty-one patients with iNPH underwent shunt surgery. Mean age of 74.4±5.2 years and mean follow-up period of 25.4±20.7 months were noted. Seven patients (17.1%) experienced SDH after VP shunt. Burr-hole trephination (n=4, 57%), change of the pressure setting of the programmable valve (n=2, 28%), combination of closed drainage and control valve (n=1, 14%) was performed.
Conclusion
The management of SDH after VPS in iNPH patients can be categorized into three methods, burr hole trephination, pressure control of shunt valve, or combination therapy. The decision making has to be performed according to patient clinical condition and response to each therapy.
Key Words: Subdural hematomaㆍVP shuntㆍiNPH


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