Hematoma subdural crônico como complicação de derivações ventrículo-peritoneais

Jf, Salomão; Rd, Leibinger; Ym, Lima

doi:10.1590/s0004-282x1990000200014

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…As a complication of surgery, AEH occurs mostly at craniotomy sites, with possible extension under the adjacent bone due to mechanical distension of the dura away from the skull. Extradural haematomas remote from the site of surgery, as in our case was more rare [8, 9]. …”

Section: Discussionmentioning

confidence: 90%

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Paiva

Oliveira

Andrade

et al. 2010

Case Reports in Medicine

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Objective. Subdural hygroma is reported to occur in 5%–20% of all patients with closed head trauma, the treatment is controversial and in symptomatic cases surgical drainage is need. We report on a new case with remote acute epidural hematoma (AEH) after subdural hygroma drainage. Case Presentation. A 38-year-old man suffered blunt head trauma and had diffuse axonal injury grade III in CT scan. A CT scan that was late performed showed an increasing subdural fluid collection with mild mass effect and some effacement of the left lateral ventricle. We perform a trepanation with drainage of a hypertensive subdural collection with citrine aspect. Postoperative tomography demonstrated a large left AEH. Craniotomy and evacuation of the hematoma were performed. Conclusion. The mechanism of remote postoperative AEH formation is unclear. Complete reliance on neurologic monitoring, trust in an early CT scan, and a relative complacency after an apparently successful initial surgery for hygroma drainage may delay the diagnosis of this postoperative AEH.

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Section: Discussionmentioning

confidence: 90%

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Paiva

Oliveira

Andrade

et al. 2010

Case Reports in Medicine

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“…4 Preconiza- 6 Dessa forma, faz-se necessário estar atento para complicações, pois mesmo com a válvula de pressão adequada, intercorrências como Hematoma Subdural Crônico podem estar presentes em procedimentos para correção da tríade clínica da HPN.…”

Section: Discussionunclassified

Hematoma subdural crônico como complicação do tratamento de paciente com a síndrome clínica da hidrocefalia de pressão normal (HPN)<br>doi: 10.20513/2447-6595.2016v56n2p54-57

et al. 2016

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RESUMOAs complicações da Derivação Ventriculoperitoneal (DVP) podem variar de 6% a 40% nas séries da literatura, estando o hematoma subdural crônico (HSDC) presente em até 24% de algumas dessas séries. Preconiza-se o uso de uma válvula de alta pressão, para evitar uma possível hiperdrenagem, nos casos de sintomatologia semelhante à hidrocefalia de pressão normal (HPN) com grande aumento ventricular. Nesse caso, o paciente apresentou a tríade clássica de Hakim-Adams, sendo diagnosticado clinicamente com a hidrocefalia de pressão normal e submetido a uma derivação ventrículo-peritoneal com uma válvula de alta pressão. O paciente evoluiu com a formação de hematoma subdural crônico bilateral (HSDC), sendo necessária a drenagem da coleção sanguínea. O Palavras-chave: Hidrocefalia. Complicações. Hematoma subdural crônico. Síndrome de Hakim. ABSTRACTComplications of ventriculoperitoneal shunt (VPS) can range from 6 to 40% in literature series, being the chronic subdural hematoma present in up to 24% of some of these series. The use of a high pressure valve is praised to avoid a probable hyperdraining in instances of similar symptomatology to normal pressure hydrocephalus (NPH) with huge ventricular increase. In this case, the patient presented the classic Hakim-Adams' triad, being clinically diagnosed with NPH and submitted to a VPS with a high pressure valve. The patient evolved with a bilateral chronic subdural hematoma formation, being necessary a draining of this blood colection. The presented case allows to notice complications after this procedure and also a bibliographic review about NPH's physiopathology.

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Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications?

2006

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Our literature review shows that the advantages of ETV in terms of complications are almost all related to two factors: (a) the avoidance of a foreign body implantation and (b) the establishment of a 'physiological' cerebrospinal fluid (CSF) circulation. Both these kinds of achievements are particularly important in infants because of the relative high rate of some intraoperative (i.e. abdominal) and late (secondary craniosynostosis, slit-ventricle syndrome) shunt complications in this specific subset of patients. On the other side, the main factor which is claimed against ETV is the relatively high risk of immediate mortality and neurological complications. Clinical manifestations of neurological structure damage seem to be more frequent in infants, probably due to the more relevant effect of parenchymal and vascular damage in this age group; however, both the immediate mortality and neurological damage risk of ETV procedures should be weighted against the long-term mortality and the late neurological damage which is not infrequently described as a consequence of shunt malfunction and proximal shunt revision procedures. Infections are possible in both ETV and extrathecal CSF procedures, especially in infants. However, the incidence of infective complications is significantly lower in case of ETV (1-5% vs 1-20%). Moreover, different from shunting procedures, infections in children with third ventriculostomy have a more benign course, being generally controlled by antibiotic treatment alone.

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Hematoma subdural crônico como complicação de derivações ventrículo-peritoneais

Cited by 7 publications

References 16 publications

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Hematoma subdural crônico como complicação do tratamento de paciente com a síndrome clínica da hidrocefalia de pressão normal (HPN)<br>doi: 10.20513/2447-6595.2016v56n2p54-57

Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications?

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