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Case Report | Open Access

Fatal subarachnoid hemorrhage after ventriculoperitoneal shunt placement to manage communicating hydrocephalus due to melanoma leptomeningeal disease

Jonah Gordona,c, Gavin Lockarda,c, Adam Alaylia,c, Nam D. Tranb,c( )
University of South Florida Morsani College of Medicine, United States
University of South Florida Department of Neurosurgery, United States
Moffitt Cancer Center and Research Institute, United States
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Abstract

Leptomeningeal disease (LMD) is a rare, late complication of malignant cancers. In addition to causing significant neurosurgical morbidity, LMD can cause communicating hydrocephalus by disrupting the cerebrospinal fluid (CSF) outflow. We report an 18-year old female with a metastatic melanoma presenting with headaches, altered mental status, nausea, and vomiting three months following a craniotomy for a temporal melanoma brain metastasis that had extended into the lateral ventricle. A diagnosis of communicating hydrocephalus was made after brain MRI demonstrated ventriculomegaly, thus necessitating placement of a ventriculoperitoneal shunt. Despite an initial improvement in symptoms, the patient quickly deteriorated within six hours following shunt placement and expired following a diffuse subarachnoid hemorrhage. This represents an important complication to consider in patients with leptomeningeal metastases and warrants future exploration to determine incidence and etiology.

Keywords

Ventriculoperitoneal shuntSubarachnoid hemorrhageLeptomeningeal melanomatosisCommunicating hydrocephalus

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Brain Hemorrhages
Volume 4 Issue 2,
June 2023
Pages 69-71
DOI: 10.1016/j.hest.2022.06.003
Cite this article:
Gordon J, Lockard G, Alayli A, et al. Fatal subarachnoid hemorrhage after ventriculoperitoneal shunt placement to manage communicating hydrocephalus due to melanoma leptomeningeal disease. Brain Hemorrhages, 2023, 4(2): 69-71. https://doi.org/10.1016/j.hest.2022.06.003

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Received: 06 June 2022
Revised: 14 June 2022
Accepted: 15 June 2022
Published: 20 June 2022
© 2022 International Hemorrhagic Stroke Association.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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