n South African Journal of Child Health - Massive bilateral chronic subdural haematoma after ventriculoperitoneal shunt : clinical images

Volume 3, Issue 1
  • ISSN : 1994-3032
  • E-ISSN: 1999-7671



A 12-year-old boy who had previously undergone a right ventriculoperitoneal shunt for obstructive hydrocephalus secondary to congenital aqueductal stenosis, presented with headache and vomiting (and no localising neurological signs). The shunt chamber was collapsed and did not fill even after applying pressure. His symptoms were suspected to be the result of shunt malfunction; however, a computed tomography (CT) scan revealed a massive bilateral subdural haematoma (Fig. 1). The child's condition deteriorated, and he developed weakness of the left upper arm, despite a bilateral burr hole and haematoma evacuation. He improved after insertion of a drain into the subdural space and catheter ligation (Fig. 2) and still further when the shunt was replaced with a high-pressure shunt system (Fig. 3). His headache and vomiting subsided, and he remains asymptomatic at follow-up.

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