Two rare cases of intracerebral hematoma which were encountered immediately after the surgical treatment of an intracranial chronic subdural hematoma were reported. In Case 1, a 70-year-old man deteriorated immediately following the irrigation of a chronic subdural hematoma. The carotid angiogram obtained two hours after the operation revealed a subcortical hemorrhage beneath the previously operated area, and this intracerebral hematoma was verified by the second operation four hours after the first. In Case 2, a 78-year-old woman immediately developed complete left hemiplegia and a drowsy state after removal of chronic subdural hematoma by craniotomy. About twenty hours after the operation, a follow-up CT scan revealed an intracerebral hematoma just beneath the previously removed hematoma in the right temporo-parietal lobe. Based on these experiences, although rare, the development of an intracerebral hemorrhage must be considered if a patient deteriorates immediately following surgical treatment of a chronic subdural hematoma. The possible reasons for the appearance of such intracerebral hematomas were also discussed.
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