A reverse brain herniation (RBH) after ventriculoperitoneal shunt (VP) in posterior fossa tumour with obstructive hydrocephalus

A reverse brain herniation (RBH) after ventriculoperitoneal shunt (VP) in posterior fossa tumour with obstructive hydrocephalus

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The risk of hydrocephalus in posterior fossa tumour is quite high (71- 90%), cerebrospinal fluid (CSF) diversion procedures like ventriculoperitoneal (VP) shunt, Endoscopic third ventriculostomy (ETV) and external ventricular drainage (EVD) are emergency procedures and may improve symptoms like headache and vomiting.However, post-operative deterioration after CSF diversion should alert the clinician to the opi meet my decorator possibility of RBH which is rare (3%) and has a high mortality.We report a case of a 12-year female child with a left cerebellar lesion with hydrocephalus.

VP shunt was done and her pupils revert back to normal size, two hours post-surgery her pupils become dilated and not reacting to light, an urgent CT was done which showed reverse brain herniation.Reverse brain herniation is a very rare complication after the ultrastar dc hc550 CSF diversion procedure with a poor prognosis.