Ventriculoperitoneal (VP) Shunt-Associated Calcified Chronic Subdural Hematoma: Armored Brain Management With Shunt Revision

TL;DR

A 14-year-old with a VP shunt developed a rare armored brain condition, which was managed successfully with shunt revision.

Contribution

This case highlights the management of calcified chronic subdural hematoma following VP shunting in a pediatric patient.

Findings

A 14-year-old male with cerebral palsy and a VP shunt presented with calcified chronic subdural hematoma.

Shunt revision led to asymptomatic recovery over two years of follow-up.

Individualized management based on clinical and imaging findings is crucial for such cases.

Abstract

Calcified chronic subdural hematoma (CCSDH) or "armored brain" is a rare, late-stage complication that has been reported more often in children and young adults and may arise after ventriculoperitoneal (VP) shunting. We present a case of a 14-year-old male patient with cerebral palsy and a VP shunt presenting with intermittent headache. A non-contrast CT scan was consistent with bilateral CCSDH. The patient underwent shunt revision and remained asymptomatic during a follow-up period of two years. Through this case, we illustrate the importance of individualized management guided by clinical and imaging findings.

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