Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Delayed Intracerebral Hematoma after Ventriculoperitoneal Shunt in the Context of Ruptured Brain AVM: Possible Underlying Mechanisms and Literature Review

Guillaume Dannhoff
,
Charles-Henry Mallereau
ORCID logo ,
Salvatore Chibbaro
* ,
Mario Ganau
ORCID logo ,
Martial Agbo-Panzo
,
Marie des Neiges Santin
,
Irène Ollivier
ORCID logo ,
Raoul Pop
,
François Proust
,
Julien Todeschi
Version 1 : Received: 19 July 2023 / Approved: 20 July 2023 / Online: 21 July 2023 (02:27:00 CEST)

A peer-reviewed article of this Preprint also exists.

Dannhoff, G.; Chibbaro, S.; Mallereau, C.-H.; Ganau, M.; Agbo-Ponzo, M.; Santin, M.N.; Ollivier, I.; Pop, R.; Proust, F.; Todeschi, J. Delayed Intracerebral Hematoma after Ventriculoperitoneal Shunt in the Context of Ruptured Brain Arteriovenous Malformation: A Literature Review. Brain Sci. 2023, 13, 1159. Dannhoff, G.; Chibbaro, S.; Mallereau, C.-H.; Ganau, M.; Agbo-Ponzo, M.; Santin, M.N.; Ollivier, I.; Pop, R.; Proust, F.; Todeschi, J. Delayed Intracerebral Hematoma after Ventriculoperitoneal Shunt in the Context of Ruptured Brain Arteriovenous Malformation: A Literature Review. Brain Sci. 2023, 13, 1159.

Abstract

Hemorrhagic complications arising from ventricular drainage procedures are typically asymptomatic and of low volume. A particular subset of these complications known as Delayed Intracranial Hemorrhage (DICH) is however recognized for its particularly poor prognosis. We primarily aimed to identify epidemiological characteristics associated with DICH, to shed light on its occurrence and potential risk factors. To do so, we performed a retrospective analysis of a series of ten patients who presented with DICH in the context of a ruptured brain Arteriovenous Malformation (bAVM), and a systematic literature review of all DICH cases reported in the literature. Our ten patients showed delayed neurological deterioration after Ventriculoperitoneal Shunt (VPS) procedure, with a computed tomography (CT) scan revealing a DICH surrounding the ventricular catheter, distinct and away from the nidus of their previously ruptured bAVM. Four patients (40%) rapidly declined and passed away, three (30%) required surgical management and the remaining three (30%) demonstrated gradual clinical improvement with conservative management. In the literature, most patients presenting with DICH had hydrocephalus associated with neurovascular disorders (47% of cases), such as bAVM rupture in our present series. These constatations point out the significance of underlying pathologies potentially predisposing to these unusual complications.

Keywords

Hydrocephalus; Brain Hemorrhage; Arteriovenous Malformation; Ventriculoperitoneal Shunt

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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