Epidural and subdural haematomas as a complication of internal drainage of cerebrospinal fluid in hydrocephalus

Driesen, W; Elies, W.

doi:10.1007/bf01405757

Cited by 43 publications

(25 citation statements)

References 12 publications

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“…These facts suggest that neurosurgical procedures which open the CSF space and intracranial hypotension caused by VP shunt procedures might facilitate the formation of postoperative CSDH. 6,39) Our series also included seven pediatric patients with CSDH, four of whom had associated arachnoid cysts. This high incidence of association with arachnoid cyst in pediatric cases was statistically significant.…”

Section: Discussionmentioning

confidence: 42%

Surgical Treatment of Chronic Subdural Hematoma in 500 Consecutive Cases: Clinical Characteristics, Surgical Outcome, Complications, and Recurrence Rate.

Mori

Maëda

2001

Neurol. Med. Chir.(Tokyo)

457

335

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Chronic subdural hematoma (CSDH) is one of the most common clinical entities in daily neurosurgical practice. The diagnosis and treatment are well established, but recurrence, complications, and factors related to these problems, especially in the elderly, are not completely understood. This study evaluated the clinical features, radiological findings, and surgical results in a large series of the patients treated at the same institution. 500 consecutive patients (359 men and 141 women) with CSDH were treated by burr hole craniostomy with closed system drainage from January 1987 through February 1999. Causes, clinical and computed tomographic findings, surgical results, re-expansion of brain after surgery, and hematoma recurrence were statistically analyzed to elucidate the potential risks of CSDH. Most patients (89.4%) had good recovery, 8.4% showed no change, and 2.2% worsened. Six patients (1.2%) died, three due to disseminated intravascular coagulation. Recurrence of hematoma was recognized in 49 patients (9.8%), at 1 to 8 weeks (3.5 ± 1.9 weeks) after the first operation. The brain reexpansion rate at one week after operation was 45.0 ± 21.4% in patients with hematoma recurrence and significantly lower than 55.3 ± 19.1% in patients without recurrence (p º 0.001). Old age, preexisting cerebral infarction, and persistence of subdural air after surgery were significantly correlated with poor brain re-expansion (p º 0.001). Twenty-seven patients (5.4%) suffered postoperative complications, of which 13 cases were acute subdural hematoma caused by incomplete hemostasis of the scalp wound and four cases were tension pneumocephalus. Careful hemostasis and complete replacement of subdural hematoma by normal saline to prevent influx of air into the subdural space will further improve the surgical outcome for patients with CSDH.

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Section: Discussionmentioning

confidence: 42%

Surgical Treatment of Chronic Subdural Hematoma in 500 Consecutive Cases: Clinical Characteristics, Surgical Outcome, Complications, and Recurrence Rate.

Mori

Maëda

2001

Neurol. Med. Chir.(Tokyo)

457

335

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“…It is a catastrophic complication of a relatively minor neurosurgical procedure. EH, as a complication of ventricular drainage, was first mentioned in 1941, by Olivecrona 1 ; since then other cases have seldom been reported [2][3][4][5][6][7][8][9][10][11][12][13][14][15] .…”

supporting

confidence: 44%

“…Many authors thought that the traction exerted on the duramater by the many vessels attached to the brain causes a displacement and makes the vessels between the membrane and the skull to be torn. A sudden lowering of intracranial pressure, due to cortex collapse, helps hematomas increasing up to a catastrophic complication if not recognized and treated in time 3,4,10,16,17,18 .…”

Section: Discussionmentioning

confidence: 40%

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Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

Pereira

Porto

Holanda³

et al. 1998

Arq. Neuro-Psiquiatr.

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ABSTRACT-Ventriculoperitoneal shunt operations represent the most used choice for treating hydrocephalus, although some related complications have been reported. Due to its rarity, potential dangers, and mortality rate, we present two cases of epidural hematoma following ventriculoperitoneal shunt, discussing its pathophysiology and prophylaxis.KEY WORDS: epidural hematoma, complications, cerebrospinal fluid shunts. Hematoma epidural após derivação ventriculoperitoneal: relato de dois casosRESUMO -No tratamento cirúrgico da hidrocefalia, a derivação ventriculoperitoneal é a mais usada, porém ocorrem várias complicações e dentre elas o hematoma epidural. Os autores relatam dois casos de hematoma epidural após cirurgia de derivacão ventriculoperitoneal e discutem sua provável fisiopatologia e profilaxia. PALAVRAS-CHAVE: hematoma epidural, complicações, derivações do líquido cefalorraquidiano.

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“…13 EDH complications generally arise within a few hours after the operation, but the time cited in the literature ranges from a few hours to even 3 years after surgery. 16,17 The symptoms arise rapidly in cases of acute EDH; however, if the bleeding is slow, patients can remain asymptomatic, delaying diagnosis and resulting in adverse outcomes. 10 Byrappa et al suggested two reasons for such a delay.…”

Section: Discussionmentioning

confidence: 43%

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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Epidural and subdural haematomas as a complication of internal drainage of cerebrospinal fluid in hydrocephalus

Cited by 43 publications

References 12 publications

Surgical Treatment of Chronic Subdural Hematoma in 500 Consecutive Cases: Clinical Characteristics, Surgical Outcome, Complications, and Recurrence Rate.

Surgical Treatment of Chronic Subdural Hematoma in 500 Consecutive Cases: Clinical Characteristics, Surgical Outcome, Complications, and Recurrence Rate.

Epidural hematoma after ventriculoperitoneal shunt surgery: report of two cases

Epidural hematoma: postoperative complication

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