Case 59

Harutomo Hasegawa, Matthew Crocker and Pawan Singh Minhas

in Oxford Case Histories in Neurosurgery

Published on behalf of Oxford University Press

Published in print March 2013 | ISBN: 9780199599837
Published online April 2013 | e-ISBN: 9780191753503 | DOI:

Series: Oxford Case Histories

Case 59

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  • Neurosurgery
  • Clinical Radiology
  • Paediatrics


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A district general hospital refers a 30-year-old woman who presented to the emergency department following three generalized tonic–clonic seizures. She has a VP shunt which was inserted following traumatic intracranial haemorrhage at 15 months of age. She has had numerous shunt revisions, the last of which was 3 months ago. For the past 2 days, her family noted that she was quiet and not her usual self, although she herself did not complain of any symptoms. On arrival at the local emergency department she was post-ictal and drowsy but responsive with a GCS of 12/15 (E3, V3, M6). During assessment she deteriorates to a GCS of 3/15 and is intubated. Her pupils are size 3, equal and reactive. Her CT scan is shown in Fig. 59.1.

Chapter.  1567 words.  Illustrated.

Subjects: Neurosurgery ; Clinical Radiology ; Paediatrics

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