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CSF overshunting-associated bilateral subdural hematoma

Case contributed by Ahmed A. Khawwam
Diagnosis almost certain

Presentation

Patient with a history of hydrocephalus presented with headache after ventriculoperitoneal shunt placement

Patient Data

Age: 70 years
Gender: Male

Right-sided ventriculoperitoneal shunt with slit-like ventricles (a sign of overshunting).

Bilateral moderate subacute subdural hematoma.

Case Discussion

Elderly male with history of hydrocephalus presented with headache after placement of ventriculoperitoneal shunt.

Findings consistent with subdural hematoma due to overshunting (a known complication of VP shunt) due to stretching of bridging veins as the brain sinks away from the skull as the pressure inside the ventricles drops after shunting.

Case courtesy of Dr. Sattar Al Eisawi, consultant radiologist

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