Contralateral extraaxial hematomas after urgent neurosurgery of a mass lesion in patients with traumatic brain injury

Abstract

Contralateral extraaxial hematoma is a rare entity, although it has a high mortality rate. Therefore, it requires a high index of suspicion, especially in patients with severe TBI, with minimal contralateral injury and mainly with contralateral skull fracture on the initial CT scan.

Spectrum of remote site extradural hematomas following decompressive craniectomy: Does fracture always co-exist?

“…In the previous studies, certain predictors of postoperative EDH have been reported, the most important of which is the presence of skull fractures [ Table 2 ]. [ 4 , 5 , 8 , 10 , 13 , 15 , 17 - 19 ] Most commonly, the hematoma occurs on the contralateral calvarium, usually with an overlying fracture, the most consistent finding. A younger age, probably related to easiness of dural stripping, and fractures involving multiple calvarial bone plates are identified as independent risk factors in the presence of fractures.…”

“…The other viable option which allows early detection of the hematomas is performing an ultrasound intraoperatively in susceptible patients such as those with persistent brain bulge. [ 5 ] Given the fact that patients operated for severe TBI are invariably shifted unreversed and electively ventilated, as part of ICP reduction measures in many centers, we prefer obtaining routine immediate postoperative CT scans in these patients.…”

“…Development of remote site extradural hematoma (EDH) following decompressive hemicraniectomies for traumatic brain injury (TBI) is a rare but potentially devastating complication with reported incidence in the range of 5–12%. [ 5 , 13 , 14 ] These hematomas are usually seen on the contralateral side, and in association with an overlying fracture. The related literature is limited to mostly sporadic case reports, and few small series, the latter comprising predominantly those with fractures.…”

“…The related literature is limited to mostly sporadic case reports, and few small series, the latter comprising predominantly those with fractures. [ 1 , 5 , 13 , 14 ]…”

Extradural hematoma following decompressive craniectomy for acute subdural hematoma: Two case reports illustrating different mechanisms

“…The occurrence of extradural hematoma (EDH), following DC for SDH, is rare with about 50 reported cases. [ 1 2 3 4 5 6 7 8 9 10 11 ] We report two cases of EDH, one developing ipsilateral and the other contralateral, following DC and evacuation of SDH. The differences in clinical presentation, pathogenesis, image findings, and outcomes are highlighted.…”