Delayed onset of traumatic extradural hematoma

Borovich, B; Braun, Jacob; Guilburd, Joseph N.; Zaaroor, Menashe; Michich, Michel; Levy, L.N.; Lemberger, Anshel; Grushkiewicz, I; Feinsod, Moshé; I, Schachter

doi:10.3171/jns.1985.63.1.0030

Cited by 97 publications

(51 citation statements)

References 24 publications

(4 reference statements)

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“…Reduction in ICP after decompression likely plays an important role. 8,43,86 Piepmeier and Wagner, 63 however, have pointed out that if tamponade relief underlies contralateral bleeding, then one would expect delayed EDH lesions more frequently. High Rotterdam scores of initial CT scans have been observed to correlate with the development of contralateral extraaxial hemorrhages.…”

Section: Perioperative Complicationsmentioning

confidence: 99%

“…Decompressive surgery may relieve the tamponade effect on a contralateral bleeding site and predispose the patient to an EDH. 8,86 In general, the severity of the underlying TBI most strongly determines prognosis. Prompt awareness and evacuation of the delayed EDH may not impair recovery as long as the mass effect has not progressed to the stage of impairing brainstem function.…”

Section: Perioperative Complicationsmentioning

confidence: 99%

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Complications of decompressive craniectomy for traumatic brain injury

Stiver¹

2009

FOC

372

302

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Decompressive craniectomy is widely used to treat intracranial hypertension following traumatic brain injury (TBI). Two randomized trials are currently underway to further evaluate the effectiveness of decompressive craniectomy for TBI. Complications of this procedure have major ramifications on the risk-benefit balance in decision-making during evaluation of potential surgical candidates. To further evaluate the complications of decompressive craniectomy, a review of the literature was performed following a detailed search of PubMed between 1980 and 2009. The author restricted her study to literature pertaining to decompressive craniectomy for patients with TBI. An understanding of the pathophysiological events that accompany removal of a large piece of skull bone provides a foundation for understanding many of the complications associated with decompressive craniectomy. The author determined that decompressive craniectomy is not a simple, straightforward operation without adverse effects. Rather, numerous complications may arise, and they do so in a sequential fashion at specific time points following surgical decompression. Expansion of contusions, new subdural and epidural hematomas contralateral to the decompressed hemisphere, and external cerebral herniation typify the early perioperative complications of decompressive craniectomy for TBI. Within the 1st week following decompression, CSF circulation derangements manifest commonly as subdural hygromas. Paradoxical herniation following lumbar puncture in the setting of a large skull defect is a rare, potentially fatal complication that can be prevented and treated if recognized early. During the later phases of recovery, patients may develop a new cognitive, neurological, or psychological deficit termed syndrome of the trephined. In the longer term, a persistent vegetative state is the most devastating of outcomes of decompressive craniectomy. The risk of complications following decompressive craniectomy is weighed against the life-threatening circumstances under which this surgery is performed. Ongoing trials will define whether this balance supports surgical decompression as a first-line treatment for TBI.

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Section: Perioperative Complicationsmentioning

confidence: 99%

Section: Perioperative Complicationsmentioning

confidence: 99%

Complications of decompressive craniectomy for traumatic brain injury

Stiver¹

2009

FOC

372

302

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show abstract

“…After head injury, the risk of extra-dural haemorrhage typically peaks within a few hours. However, it can occur 24 hours after the initial injury 19 and some information leaflets reflected this information in the recommended surveillance period for complications. 6,20 What should clinicians do now?…”

Section: Being More Precise About Time Coursementioning

confidence: 99%

Diagnostic safety-netting

Almond¹,

Mant²,

Thompson³

2009

Br J Gen Pract

127

123

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“…Chronic EHs, however, have been reported (Iwakuma and Brunngraber, 1973;Hirsh, 1980;Borovich et al, 1985;Poon et al, 1992).…”

Section: Evidence For Venous Originmentioning

confidence: 96%

Middle meningeal artery hemorrhage: An incorrect name

et al. 2006

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Extradural hemorrhage is most commonly assumed to result from a middle meningeal artery rupture. This article challenges that assumption. The meningeal vasculature of 29 cadaveric specimens was examined macroscopically and microscopically at the level of the greater wing of the sphenoid bone and foramen spinosum. It was observed that the middle meningeal artery is accompanied by a pair of dural sinuses throughout the majority of its course, thus making exclusively arterial rupture an anatomical improbability. Furthermore, as these dural sinuses pass caudally through the foramen spinosum with the middle meningeal artery, they were seen to diverge to form a plexiform arrangement around the artery. This has not been reported before.

show abstract

Delayed onset of traumatic extradural hematoma

Cited by 97 publications

References 24 publications

Complications of decompressive craniectomy for traumatic brain injury

Complications of decompressive craniectomy for traumatic brain injury

Diagnostic safety-netting

Middle meningeal artery hemorrhage: An incorrect name

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