Ventriculosubgaleal shunt in the management of obstructive hydrocephalus caused by cerebellar infarction

ABSTRACT

Cerebellar infarction is relatively uncommon. Small infarctions only cause cerebellar manifestations e.g. ataxia and nystagmus and are treated medically. Large cerebellar infarctions, however, can be life threatening. It cause brain stem compression and can obstruct the cerebrospinal fluid pathway causing obstructive hydrocephalus. It has to be treated promptly and may require besides the medical treatment surgical intervention as well. This is mainly in the form of posterior fossa decompression. In this study, we studied the beneficial effect of inserting a temporary ventriculoperitoneal shunt to relieve the supratentorial hydrocephalus in addition to posterior fossa decompression on the morbidity and mortality of patients in comparison to posterior fossa decompression alone. The aim of this study was to evaluate the role of ventriculosubgaleal shunt in cerebellar infarction causing supratentorial ventricular dilatation. This was a retrospective study that included ten patients having extensive cerebellar infarction causing spratentorial hydrocephalus. They were divided into two groups, group [1] was submitted to posterior fossa decompression alone and group [2] was submitted to posterior fossa decompression in addition to temporary ventriculosubgaleal shunt insertion. Group [2] which had posterior fossa decompression in addition to temporary. ventriculosubgaleal shunt hadmuch better results than group [1] which had only posterior fossa decompression. Group [2] had a lower morbidity and mortality and a shorter hospital stay than group [1]. Temporary insertion of ventriculosubgaleal shunt is recommended in patients having extensive cerebellar infarction causing supratentorial hydrocephalus in addition to posterior fossa decompression. It results in a lower morbidity and mortality and a shorter hospital stay