Case Report of a Post-Traumatic Hydrocephalus Patient: Ventriculo-Vesicle Shunt With a Review of the Literature

• Published in: Korean journal of neurotrauma 2023, 19(3), , pp.370-375
• Main Authors: Lee, Gyubin, Whang, Kum, Cho, Sungmin, Kim, Jongyeon, Kim, Byeongoh, Jang, Yeongyu, Choi, Jongwook
• Format: Article
• Language: English
• Subjects: Current Issue; 신경외과학
• ISSN: 2234-8999; 2288-2243
• DOI: 10.13004/kjnt.2023.19.e52

Post-traumatic hydrocephalus (PTH) is treated through cerebrospinal fluid (CSF) diversion, typically through ventriculoperitoneal shunt (VPS) or other bypass techniques. As these shunts are associated with significant complications and high revision rates in certain populations, it is important to tailor a patient’s shunt procedure according to their medical history and complications. Herein, we report the case of a 30-year-old man with PTH following a traffic accident on a motorcycle. VPS was chosen as the method of treatment but required multiple revisions and replacements due to persistent complications such as post-operative infection, shunt obstruction and abdominal problem. As the patient’s heart failure and pleural effusion rendered both ventriculopleural and ventriculoatrial shunt not feasible, it was decided to move the shunt to the bladder (ventriculo-vesicle shunt [VVS]) in cooperation with a urologist. Follow-up examinations after about 3 months showed a decrease in ventricle size, improved hydrocephalus, and no complications such as urinary infection or bladder stone formation. In cases where the patient’s underlying conditions, such as heart failure and pleural effusion, make it unsuitable to choose the pleural cavity or atrium as non-peritoneal spaces, VVS can be a suitable option for continuous CSF drainage when complications have occurred with the previous VPS.