Development of subdural hematoma in patients which was applied ventriculoperitoneal shunt surgery

Subdural hematomas (SDH) are type of bleeding that develops as a result of head trauma, tension of the bridging veins secondary to cerebral atrophy, decrease of intracranial pressure and antiaggregant/thrombolytic use are other etiological reasons. In this thesis, it is aimed to determine possible risk factors that facilitate the development of SDH after vetriculoperitoneal (VP) shunt surgery. Patients who underwent VP shunt surgery between 2010 and 2020 in our clinic and who developed SDH after at least 3 months of follow-up were retrospectively analyzed. The patients age, gender, preoperative Evans index, preoperative head circumference, type of hydrocephalus, side and point of the shunt insertion, type of VP shunt used, accompanying diseases, and anticoagulant drug use were recorded. For statistical analysis of data, Pearson Chi-square test was used for comparing categorical variables between groups, and Mann-Whitney U test was used for comparison of independent groups for non-normally distributed continuous data. The level of significance was set at p <0,05. It was observed that SDH developed in 79 (15%) of 499 patients included in this thesis after VP shunt surgery. An increased risk of SDH was observed in pediatric patients above 2 years of age and in adult patients above 58 years of age. In addition, SDH development rate was more frequent in patients who were placed ventricular catheter using the male gender and Kocher entry point (p<0,05). SDH development was detected in the majority of patients (35%) within the first month after VP shunt surgery. Acetylsalicylic acid use, head circumference less than 52 cm in adult patients and Evans index over 48% in pediatric patients were seen as risk factors that facilitate the development of SDH. Older age, male gender, Evans index > 48%, Kocher entry point, use of acetylsalicylic acid are significant risk factors for the development of SDH after VP shunt surgery. Key words: Hydrocephalus, subdural hematoma, ventriculoperitoneal shunt surgery.