Contralateral Acute Subdural Hematoma Following Traumatic Acute Subdural Hematoma Evacuation

Shen, Jian; Fan, Zuoxu; Ji, Tao; Pan, Jianwei; Zhou, Yangfan; Zhan, Renya

doi:10.2176/nmc.53.221

Cited by 20 publications

(15 citation statements)

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“…7 Time interval required to diagnosis and definitive second surgery needed varying time interval in the literature. It can range from 0.5 to 3 h in cases reported by Ban et al 6 and took one, three and 5 h respectively cases operated and managed by Matsuno et al, 2 and it took about 3 h in a case managed by Shen et al 5 However no data of time-interval is available in either 81-year female underwent surgery in year 2010 reported by Tomycz et al 3 or 85 year-old operated by Fridley et al 1 However, current case is the first case to the best of knowledge of authors in western literature, which was diagnosed during first surgery and even got operated in continuity.…”

Section: Discussionmentioning

confidence: 96%

“…It can be diagnosed with CT scan or intraoperative ultrasonography. 5 In extradural hematoma, fracture of contralateral skull should be evident. 9 In present case, compression from left sided ASDH with midline shift probably prevented contralateral subdural hematomas from developing but following evacuation of first hematoma led to decrease in intracranial tension and evolution of hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…head elevation to encourage venous drainage, securing air way patency, correction over-rotation of head, intravenous osmotic agent administration, correction of air way obstruction like endotrachecal tube kinking, hyperventilation, stopping inhalation anesthetic agent, switching over to total intravenous anesthetic management regimen and possibility of hematoma development on contralateral side should be kept as potential cause, requires urgent attention, necessitating immediate CT scan for correct diagnosis with emergency planning of management. 1,3,5,7 Authors report an interesting case of severe head injury with acute ASDH, who developed acute brain bulge intraoperatively, NCCT head showed contralateral massive ASDH, which needed emergency surgical evacuation. This case emphasizes getting immediate CT scan directly from operating room and return to carry out evacuation of contralateral ASDH.…”

Section: Introductionmentioning

confidence: 99%

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Contralateral development of massive acute subdural hematoma occurrence during decompressive craniectomy and surgery for evacuation of ipsilateral acute subdural hematoma: Literature review

Satyarthee

Gaurang

Sharma

2014

The Indian Journal of Neurotrauma

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IntraoperativeAcute subdural hematoma Surgery Brain bulge a b s t r a c t Contralateral massive acute subdural hematoma (ASDH) developing acutely during decompressive craniectomy for severe head injury with ASDH evacuation is very rare occurrence. Till date about seven cases are published in the western literature with outcome varying from death, vegetative existence and severe disability. Interestingly all seven cases were operated at varying time-interval following first surgery varying from 0.5 to 3 h following initial surgery. Current case is the first case in the best of knowledge of authors in western literature, who was diagnosed even got operated in continuity with good neurological outcome. Awareness of intraoperative brain swelling is important.Author presents a case occurring in a 45-year old male, developed acute subdural hematoma on contralateral side during decompressive surgery, causing sudden brain bulge, refractory to medical management, however, wound was closed rapidly and urgent CT scan carried out, revealed massive acute subdural hematoma, requiring immediate decompressive surgical intervention. In the immediate postoperative period, he required ventilatory support and discharged after two weeks following surgery. High degree of suspicion, brain bulge during surgery not relieving with routine measure warrants immediate CT scan and a rapid return to the operating room for immediate surgical intervention for acute SDH evacuation can provide good outcome. www.els evier.com/locate/ijnt t h e i n d i a n j o u r n a l o f n e u r o t r a u m a 1 1 ( 2 0 1 4 ) 1 1 8 e1 2 1

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contralateral development of massive acute subdural hematoma occurrence during decompressive craniectomy and surgery for evacuation of ipsilateral acute subdural hematoma: Literature review

Satyarthee

Gaurang

Sharma

2014

The Indian Journal of Neurotrauma

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“…However, many complications may occur following the procedure [1,2]. Remote acute subdural hematoma (ASDH) following a decompressive craniotomy or craniectomy is a rare phenomenon [3,4]. Patients with ASDH suffer a high mortality and morbidity, despite modern surgical, medical and technological advances [4,5].…”

Section: Introductionmentioning

confidence: 99%

Remote Supratentorial Subdural Hematoma Following Craniectomy and Evacuation of Hypertensive Cerebellar Hematoma

Pradhan

Shrestha

Sedain

2020

Cureus

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Remote acute subdural hematoma following a decompressive craniotomy or craniectomy is a rare phenomenon. Only few cases of postoperative contralateral acute subdural hematomas have been reported in the literature review till date. This case report details a case of a 32-yearold hypertensive male who presented with severe headache, multiple episodes of vomiting, slurring of speech, nystagmus and ataxic gait for one day. Computed tomography (CT) scan of head revealed a right sided cerebellar hemorrhage with effacement of fourth ventricle and upstream hydrocephalus. A right suboccipital craniectomy and hematoma evacuation were performed. A repeat CT scan of head was done at six hours post surgery; which revealed a contralateral (left-sided) subdural hematoma involving the fronto-parieto-temporal region. The patient improved following conservative management. Contralateral acute subdural hematoma following evacuation of hematoma is a rare, but a potentially life-threatening complication; therefore, we should try to detect such contralateral hematoma and prevent clinical deterioration.

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“…However, the contralateral ASDH is worthy of more attention, since this rare complication can lead to lifethreatening diseases if not recognized [16].…”

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confidence: 99%

Traumatic brain injury (TBI): morbidity, mortality and economic implications

Souza¹,

Pinheiro²,

Silva³

et al. 2015

Int Arch Med

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Traumatisms, in general, result in high costs for health systems worldwide. They consist of the leading cause of death in young adults, primarily males. Traumatic brain injury (TBI) represents good part of this spending, reaching globally significant mortality rate, around 1.5 million victims a year. Only in the United States (US) attendances related to traumatic brain injuries in emergency departments revolve around 1.35 million annually, plus about 275,000 hospitalizations and 52,000 deaths. In Brazil, only in 2012 was spent over one billion dollars with hospitalizations related to external causes, including TBI. Mild TBI (Glasgow Coma Scale (GCS) 14-15) occur in about 80% of the total demand, moderate (GCS 9-13) in 10% and serious (GCS 3-8) in 10 %. Regarding mortality rate, this is relatively low compared to the total number, since much of fatal outcomes fits in the moderate to severe groups. One of lesions a valuable prognostic factor related to the TBI is the subdural hematoma (SDH), responsible for complications in up to 45% of cases of TBI, expressing mortality between 60-80% depending on the implemented workup and may even reach 90% when in delay of appropriate treatment. The acute subdural hematoma (ASDH) thus represents a neurosurgical emergency, taking most of these patients to be subjected to urgent evacuation of the hematoma by craniotomy, which also is not without risks, with several reports in literature of new contralateral hematoma formation after craniotomy for evacuation of hematoma, further aggravating the patient's prognosis. For best results of the TBI is needed better understanding of the pathophysiology, identification of newer parameters of brain function and development of innovative therapeutic modalities. According to the Centers for Disease Control and Prevention (CDC), under the Department of Health and Human Services, population data on TBI are fundamental for understanding its impact on the society and know the profile of patients and the mechanisms trauma, to assist in the formulation of prevention strategies and in setting priorities for research and support services to patients living with traumatic brain injury.

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Contralateral Acute Subdural Hematoma Following Traumatic Acute Subdural Hematoma Evacuation

Cited by 20 publications

References 20 publications

Contralateral development of massive acute subdural hematoma occurrence during decompressive craniectomy and surgery for evacuation of ipsilateral acute subdural hematoma: Literature review

Contralateral development of massive acute subdural hematoma occurrence during decompressive craniectomy and surgery for evacuation of ipsilateral acute subdural hematoma: Literature review

Remote Supratentorial Subdural Hematoma Following Craniectomy and Evacuation of Hypertensive Cerebellar Hematoma

Traumatic brain injury (TBI): morbidity, mortality and economic implications

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