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  • Title: Delayed isolated tension intraventricular pneumocephalus after ventriculoperitoneal shunt.
    Author: Mineo JF, Phong DH, Seizeur R, Mériot P, Besson G.
    Journal: Neurochirurgie; 2004 Jun; 50(2-3 Pt 1):96-100. PubMed ID: 15213637.
    Abstract:
    OBJECTIVE AND IMPORTANCE: Delayed and isolated tension intraventricular pneumocephalus without air in the pericerebral subarachnoid spaces is an exceptional complication of a ventriculoperitoneal (VP) shunt. We purpose an explanation for the development of such delayed pneumocephalus. CLINICAL PRESENTATION: A 14-year-old boy developed headaches and right-side hearing loss three months after surgical resection of a cerebellar medulloblastoma and insertion of a VP shunt. CT-scan showed isolated intraventricular pneumocephalus without air in the pericerebral subarachnoid spaces. A petrous bone defect was discovered and surgically repaired with clinical and radiographic resolution of pneumocephalus. CONCLUSION: We presume that the brain tIssue plugging the bony defect retracted following the placement of the shunt and eventually there was rupture through the pia-mater into the lateral ventricle. This could explain why isolated intraventricular occurred, as opposed to air in the subarachnoid spaces.
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