Decompressive surgery for acute subdural haematoma leading to contralateral extradural haematoma: a report of two casesand review of literature

Mohindra, Sandeep; Mukherjee, Kanchan Kumar; Gupta, Rahul; Chhabra, Rajesh; Gupta, Sunil; Khosla, Virender K.

doi:10.1080/02688690500495216

Cited by 49 publications

(39 citation statements)

References 22 publications

(33 reference statements)

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“…For example, cerebrovascular regulation disorder may cause diffuse brain swelling, and progressed cerebral contusion may cause deterioration of cerebral edema (11,15). Several cases of contralateral epidural hematoma during decompressive surgery for acute epidural hematomas have been reported (5,10,11).…”

Section: Discussionmentioning

confidence: 99%

Controlled decompression for the treatment of severe head injury: a preliminary study

Wang¹,

Wang²,

Yang³

et al. 2013

Turkish Neurosurgery

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AIm: Fast direct decompression surgery for treatment of severe head injury often results in intraoperative and postoperative complications. Controlled decompression may help prevent these complications. This preliminary study aims to compare the effects of controlled and conventional decompression in patients with severe head injury. mATeRIAL and meTHods: A total of 128 patients with severe head injury were included. Patients were allocated to receive either controlled decompression surgery (n = 64) or conventional decompressive craniectomy (n = 64). Controlled decompression comprised controlled ventricular drainage and controlled hematoma evacuation. The occurrence of delayed hematoma, acute brain swelling, and postoperative cerebral infarction were recorded. ResuLTs:Significantly lower proportion of patients in the controlled decompression group had intraoperative acute brain swelling compared to patients in the decompressive craniectomy group (9.4% vs 26.6%, P = 0.011). Intraoperative acute encephalocele occurred in 3 of 13 patients (23.1%) who had delayed hematoma in the controlled decompression group compared with 11 of 18 patients (61.1%) in the decompressive craniectomy group. There was no significant between group difference in the incidence of delayed hematoma or postoperative cerebral infarction.CoNCLusIoN: Controlled decompression may reduce or delay intraoperative acute brain swelling by delaying hematoma formation in patients with severe head injury.KeywoRds: Brain swelling, Decompressive craniectomy, Severe, Head injury, Traumatic intracranial hematoma ÖZ AmAÇ: Şiddetli kafa travmasının hızlı ve doğrudan dekompresyon cerrahisi sıklıkla intraoperatif ve postoperatif komplikasyonlara neden olur. Kontrollü dekompresyon bu komplikasyonları önlemeye yardımcı olabilir. Bu ön çalışma, şiddetli kafa travması olan hastalarda kontrollü ve geleneksel dekompresyonun etkilerini karşılaştırmayı amaçlamaktadır. yÖNTem ve GeReÇLeR: Şiddetli kafa travması olan toplam 128 hasta dahil edilmiştir. Hastalar kontrollü dekompresyon cerrahisi (n = 64) veya geleneksel dekompresif kraniyektomi (n = 64) yapılacak şekilde ayrılmışlardır. Kontrollü dekompresyon grubunda kontrollü ventriküler drenaj ve kontrollü hematom boşaltılması yapılmıştır. Gecikmiş hematom, akut beyin şişmesi ve postoperatif serebral enfarktüs oluşması kaydedilmiştir.BuLGuLAR: Kontrollü dekompresyon grubundaki hastalarda intraoperatif akut beyin şişmesi yüzdesi dekompresif kraniyektomi grubundan önemli ölçüde daha düşük olmuştur (%9,4 ve %26,6, P = 0,011). İntraoperatif akut ensefalosel, kontrollü dekompresyon grubunda gecikmiş hematomu olan 13 hastanın 3'ünde (%23,1) görülürken dekompresif kraniyektomi grubunda 18 hastanın 11'inde (%61,1) görülmüştür. Gecikmiş hematom veya postoperatif serebral enfarktüs insidansı açısından gruplar arasında önemli bir fark görülmemiştir. soNuÇ: Kontrollü dekompresyon şiddetli kafa travmalı hastalarda hematom oluşumunu geciktirerek intraoperatif akut beyin şişmesini azaltabilir veya geciktirebilir.

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Section: Discussionmentioning

confidence: 99%

Controlled decompression for the treatment of severe head injury: a preliminary study

Wang¹,

Wang²,

Yang³

et al. 2013

Turkish Neurosurgery

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“…EDH is extremely rare, with only 38 cases after decompressive craniectomy presented in the literature. [25][26][27][28][29][30] Panourias et al, Matsuno et al, and Meguins et al reported contralateral epidural hematoma after decompressive craniectomy for acute subdural hematoma. 5,31,32 Shen et al evaluated published data via Pubmed and found a rate of 2.4% for contralateral EDH after acute subdural hematoma.…”

Section: Discussionmentioning

confidence: 99%

Epidural hematoma: postoperative complication

et al. 2017

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Epidural hematoma is an indication for emergency neurosurgical intervention. This condition is an extremely rare postoperative complication of ventriculoperitoneal shunt and contralateral decompressive craniectomy. A 22-year-old male patient was admitted to our clinic with headache and a decline in the level of consciousness. We detected a left thalamic astrocytoma and hydrocephalus, which we treated via ventriculoperitoneal shunt surgery and ventricular drainage in emergency conditions. The patient experienced dysphasia on the first postoperative day and we found a right frontoparietal epidural hematoma. We evacuated the hematoma and exchanged the medium pressure valve for a high-pressure valve. The second patient was a 19-year-old male who had been assaulted. His pupils were fixed and dilated and had no reaction to painful stimulus. We detected bilateral frontotemporal skull fractures and right frontotemporoparietal subdural and epidural hematomas. We performed a right decompressive craniectomy and subdural/epidural hematoma evacuation followed by recovery under sedation in the intensive care unit. We performed cranial computed tomography six hours after surgery and found a left temporoparietal epidural hematoma. We performed a left temporoparietal craniotomy and epidural hematoma evacuation. The patient exhibited a higher level of consciousness and increased movement of his extremities. Epidural hematoma is a life-threatening complication encountered in neurosurgery practice. Neurosurgeons should be aware of the possibility of epidural hematoma following ventriculoperitoneal shunt or traumatic brain injury surgery.

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“…4,9,16,18,20) Contralateral epidural and intraparenchymal hematoma have received considerable attention in the literature, 1,11,16) but contralateral ASDH is worthy of more attention. This rare complication may lead to potentially life-threatening disorders, if unrecognized.…”

Section: Discussionmentioning

confidence: 99%

Contralateral Acute Subdural Hematoma Following Traumatic Acute Subdural Hematoma Evacuation

Shen

Fan

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Contralateral acute subdural hematoma (ASDH) occurring after removal of traumatic ASDH is a rare, but nearly devastating postoperative complication. We treated a 26-year-old male who developed a contralateral ASDH shortly after craniectomy for evacuation of a traumatic ASDH. Burr-hole craniotomy was performed before decompressive craniectomy, and the bleeding source was a cortex artery within the frontal lobe contusion. Despite supportive therapy with barbiturate and mild hypothermia he expired 3 days later of brain death. Literature review suggests that the old are more susceptible to contralateral ASDH following evacuation of traumatic ASDH. Contralateral ASDH following evacuation of traumatic ASDH is a rare but potentially lethal complication, so neurosurgeons should try to detect such contralateral hematoma formation and prevent clinical deterioration.

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Decompressive surgery for acute subdural haematoma leading to contralateral extradural haematoma: a report of two casesand review of literature

Cited by 49 publications

References 22 publications

Controlled decompression for the treatment of severe head injury: a preliminary study

Controlled decompression for the treatment of severe head injury: a preliminary study

Epidural hematoma: postoperative complication

Contralateral Acute Subdural Hematoma Following Traumatic Acute Subdural Hematoma Evacuation

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