Chronic Subdural Hematoma after Lumboperitoneal Shunt Replacement: A Case Report From Iran

Background and Importance: Lumboperitoneal shunts are commonly used to treat several conditions, but their use can result in significant complications. We discuss a complication of these shunts that has not been reported in the literature to date. Case Presentation: An obese, 41-year-old woman admitted to Rasool Akram Hospital complaining of a severe headache and blurred vision. The physical examination indicated that she had papilledema, and a lumbar puncture demonstrated cerebrospinal fluid opening pressure of 33 cm of H2O. Pseudotumor Cerebri was diagnosed, and the patient underwent surgery to insert a lumboperitoneal (LP) shunt. She suffered from severe headaches and nausea during the post-operative period. The post-operative syndrome was misdiagnosed as shunt-induced cerebellar tonsillar ptosis; however, further evaluation indicated that intracranial chronic subdural hematoma, a very rare complication subsequent to lumboperitoneal shunting, was the cause of the post-operative syndrome. Subdural hematoma was evacuated and her symptoms disappeared thereafter.  Conclusion: Persistent symptoms, such as headache, nausea, and vomiting, after placement of a lumboperitoneal shunt should be taken serious, and imaging, such as a CT of the brain, should be done to rule out subdural hematoma.