脳室腹腔シャント留置患者のリスク管理 : 転倒により脳挫傷に至った1例

概要

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We report a case of cerebral contusion in a patient with ventricle peritoneal shunt(VP shunt) caused by a simple fall. Described is a 50-year-old man admitted with left thalamic hemorrhage with resultant severe consciousness disturbance and right hemiparesis. Although his general condition and consciousness were improved after conservative treatments, two weeks later decrcased mental status and anisocoria were noted. Head computed tomography(CT) scan revealed hydrocephalus which needed VP shunt following emergent ventricular shunting. After that, intensive rehabilitation programs were started. Independent ambulation was not achieved, however he was enable to transfer with minimal assistance. CT scan showed that the size of ventricular system was extremely reduced, which is so called "slit like ventricle." During transfer from his bed to the chair he fell and his head hit the bed. Immediately after that, he fell into deep coma state. CT scan showed left subdural hematoma, contusion and diffuse brain swelling. Overdrainage is a rare complication in VP shunt, however it caused a catastrophic event followed by traumatic brain injury.
社団法人日本リハビリテーション医学会の論文
1998-01-18