Efficacy of Ventriculoperitoneal Shunt For The Management of Cerebellar Haematomas

Abstract

Object:  To determine the role of ventriculoperitoneal shunt in the management of cerebellar haemotoma with obstructive hydrocephalus.

Result:  A total of 10 cases were included in the study. Six (60%) were male and 4 (40%) were female. Age range was from 35 – 63 years. The clinical presentation was sudden severe headache, vomiting, loss of consciousness. Glasscow coma score was ⁶/₁₅ to ¹³/₁₅.^. C T Scan brain revealed cerebellar haematoma compressing the fourth ventricle with obstructive hydrocephalus. The range of volume of cerebellar haemotoma was from 20 ml to a maximum of 80 ml. Various management plan were offered, decision was done case to case basis. Three (30%) patients with mean cerebellar haemotoma volume of 30 ml (range 20-40) obstructive hydrocephalus were managed by a ventriculoperitoneal shunt (V.P. Shunt) alone. All three patients had excellent post operative recovery within a period of 2 to 4 weeks. Seven (70%) patients were operated for removal of cerebellar haematoma alongwith external ventricular drain (EVD.), which was removed on 5^th – 7^th day but in one case V.P. shunt was inserted post operatively. Result were good in 3 cases, excellent in 2 cases, fair in one case due to persistant hydrocephalus and mortality in one case. The patient who died was operated for removal of cerebellar haematoma and external ventricular drain was passed He died due to chest infection post operatively. Thus out of 10 cases V.P. shunt was done in 4 cases.