Can risk factors predict the development of subdural haematoma after shunt surgery?

Purpose Subdural haematoma is a well-recognized complication following ventriculoperitoneal shunt surgery. However, limited data exist regarding which clinical and surgical factors may predict its development. This study aims to identify specific risk factors associated with subdural haematoma formation following ventriculoperitoneal shunt placement.Materials and Methods We retrospectively analyzed 499 patients who underwent ventriculoperitoneal shunt placement between June 2010 and June 2020. Patients with a history of trauma were excluded. Demographic characteristics, surgical details, and radiological data were recorded. The primary outcome was the incidence of postoperative subdural haematoma. Statistical analyses were performed to identify significant predictors.Results Of the 499 patients included in the study, 79 (15%) developed subdural haematoma during follow-up. Univariate and multivariate analyses revealed that older age, male gender, preoperative Evans index >48%, acetylsalicylic acid use, and placement of the ventricular catheter through Kocher’s point were significantly associated with increased risk of subdural haematoma development (p < 0.05). No significant association was found with other surgical variables.Conclusion Subdural haematoma occurred in 15% of patients following ventriculoperitoneal shunt surgery. The presence of certain preoperative and perioperative factors (particularly age, sex, ventricular size, acetylsalicylic acid use, and catheter trajectory) may help identify high-risk patients. Risk-based follow-up and tailored surgical planning could potentially reduce the incidence of subdural haematoma after shunting procedures.