{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:32:35Z","timestamp":1769725955989,"version":"3.49.0"},"reference-count":8,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"14","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"\n BACKGROUND<\/jats:title>\n Secondary normal pressure hydrocephalus is a common complication in the chronic phase after subarachnoid hemorrhage or intracerebral hemorrhage, with an incidence of approximately 30%. Lumboperitoneal (LP) shunts are often selected for older patients due to their less invasive nature. However, postoperative complications such as infection, catheter malfunction, and subdural hematoma are known.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors present the first known case of symptomatic subcutaneous emphysema following LP shunt surgery, necessitating reoperation. The patient was a markedly thin woman (BMI 13.3), and the cause of the complication was determined to be a combination of shallow subcutaneous catheter placement and failure to evacuate retained air prior to closure.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n In thin patients, LP shunt catheters should be placed in deeper layers to minimize dead space and prevent air retention. In addition, care must be taken to release subcutaneous air before wound closure, especially in procedures performed in the lateral decubitus position.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE25584<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case25584","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:01:35Z","timestamp":1759795295000},"source":"Crossref","is-referenced-by-count":0,"title":["Symptomatic subcutaneous emphysema following lumboperitoneal shunt placement: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4468-7873","authenticated-orcid":true,"given":"Tomoya","family":"Sofue","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Chatani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenkichi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Kuga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Ohnishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Biomed Res Int","first-page":"8584753","article-title":"Hydrocephalus after subarachnoid hemorrhage: pathophysiology, diagnosis, and treatment","volume":"2017","author":"Chen","year":"2017","unstructured":"Chen SLuo JReis CManaenko AZhang J.Hydrocephalus after subarachnoid hemorrhage: pathophysiology, diagnosis, and treatment. Biomed Res Int. 2017;2017:8584753."},{"issue":"6","key":"bib2","series-title":"Lancet Neurol","first-page":"585","article-title":"Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial","volume":"14","author":"Kazui","year":"2015","unstructured":"Kazui HMiyajima MMori EIshikawa MSINPHONI-2 Investigators.Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol. 2015;14(6):585-594."},{"key":"bib3","series-title":"Clin Interv Aging","first-page":"477","article-title":"Clinical outcome and safety of lumboperitoneal shunt in the treatment of non-obstructive hydrocephalus","volume":"18","author":"Foo","year":"2023","unstructured":"Foo NPTun YCChang CCLin HLCheng CHChuang HY.Clinical outcome and safety of lumboperitoneal shunt in the treatment of non-obstructive hydrocephalus. Clin Interv Aging. 2023;18:477-483."},{"issue":"1","key":"bib4","series-title":"Neurosurgery","first-page":"57","article-title":"Cerebrospinal fluid dynamics and hydrocephalus after experimental subarachnoid hemorrhage","volume":"17","author":"Black","year":"1985","unstructured":"Black PMTzouras AFoley L.Cerebrospinal fluid dynamics and hydrocephalus after experimental subarachnoid hemorrhage. Neurosurgery. 1985;17(1):57-62."},{"key":"bib1","series-title":"Biomed Res Int","first-page":"8584753","article-title":"Hydrocephalus after subarachnoid hemorrhage: pathophysiology, diagnosis, and treatment","volume":"2017","author":"Chen","year":"2017","unstructured":"Chen SLuo JReis CManaenko AZhang J.Hydrocephalus after subarachnoid hemorrhage: pathophysiology, diagnosis, and treatment. Biomed Res Int. 2017;2017:8584753."},{"issue":"6","key":"bib2","series-title":"Lancet Neurol","first-page":"585","article-title":"Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial","volume":"14","author":"Kazui","year":"2015","unstructured":"Kazui HMiyajima MMori EIshikawa MSINPHONI-2 Investigators.Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol. 2015;14(6):585-594."},{"key":"bib3","series-title":"Clin Interv Aging","first-page":"477","article-title":"Clinical outcome and safety of lumboperitoneal shunt in the treatment of non-obstructive hydrocephalus","volume":"18","author":"Foo","year":"2023","unstructured":"Foo NPTun YCChang CCLin HLCheng CHChuang HY.Clinical outcome and safety of lumboperitoneal shunt in the treatment of non-obstructive hydrocephalus. Clin Interv Aging. 2023;18:477-483."},{"issue":"1","key":"bib4","series-title":"Neurosurgery","first-page":"57","article-title":"Cerebrospinal fluid dynamics and hydrocephalus after experimental subarachnoid hemorrhage","volume":"17","author":"Black","year":"1985","unstructured":"Black PMTzouras AFoley L.Cerebrospinal fluid dynamics and hydrocephalus after experimental subarachnoid hemorrhage. Neurosurgery. 1985;17(1):57-62."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/14\/article-CASE25584.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/14\/article-CASE25584.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/14\/article-CASE25584.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:13:04Z","timestamp":1769685184000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/14\/article-CASE25584.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":8,"journal-issue":{"issue":"14"},"URL":"https:\/\/doi.org\/10.3171\/case25584","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,6]]}}}