ABSTRACT
The authors describe an extremely unusual case of a giant hemicranial subdural empyema occurring nine years after insertion of a venticuloperitoneal shunt. Though the empyema was evacuated, the child suffered significant morbidity and remained hemiparetic. The present case highlights the delayed morbidity following a ventriculoperitoneal shunt insertion and the need of prolonged and regular follow up in children who have undergone this procedure.
Subject(s)
Adolescent , Calcinosis , Child , Craniotomy , Drainage , Empyema, Subdural/epidemiology , Empyema, Subdural/etiology , Empyema, Subdural/surgery , Female , Humans , Magnetic Resonance Imaging , Morbidity , Paresis/epidemiology , Paresis/etiology , Postoperative Complications , Time Factors , Treatment Outcome , Ventriculoperitoneal Shunt/adverse effectsABSTRACT
Vasospasm, so commonly described after aneurysmal rupture, is very rare after surgery for brain tumors. Its occurrence after transsphenoidal surgery is extremely uncommon with only three cases reported as per the authors' review of the literature. The authors report a case of pituitary macroadenoma in a 34-year-old female who underwent transsphenoidal tumor decompression and developed angiographically documented vasospasm during the course of her illness. The rarity of the occurrence of vasospasm after transsphenoidal surgery makes its management very challenging, frequently leading to a delay in diagnosis and a poor outcome. The key to successful management is a high index of suspicion and early proactive management.