Significance of consecutive bilateral surgeries for patients with acute subdural hematoma who develop contralateral acute epi- or subdural hematoma

Matsuno, Akira; Katayama, Haruko; Wada, Hiromi; Morikawa, Kaoru; Tanaka, Kotaro; Tanaka, Hideki; Murakami, Mineko; Fuke, Nobuo; Nagashima, Tadashi

doi:10.1016/s0090-3019(03)00023-5

Cited by 63 publications

(55 citation statements)

References 21 publications

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“…23 Evolution of Contralateral Mass Lesion. Surgical craniectomy decompression for TBI may incite a new mass lesion, contralateral or remote to the decompressed hemisphere 13,52,63 (Fig. 3).…”

Section: Perioperative Complicationsmentioning

confidence: 99%

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%

Complications of decompressive craniectomy for traumatic brain injury

Stiver¹

2009

FOC

372

302

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“…We reviewed the literature to identify cases of contralateral ASDH occurring immediately after evacuation of traumatic ASDH, as summarized in Table 1. 1,4,9,18) The present case was 1 of 126 cases (0.8%) treated at our facility for ASDH. The pathophysiologic mechanisms of contralateral ASDH occurring after ASDH evacuation are not clear.…”

Section: Discussionmentioning

confidence: 66%

“…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%

“…14,15,19) Decompressive craniectomy in the management of patients with ASDH have been justified by various reports, 3,8,20) but complications secondary to surgical decompression are likely to adversely affect outcome. 9,16,20) Contralateral ASDH occurring after removal of traumatic ASDH have been reported recently as a rare but potentially lethal postoperative complication which requires consecutive operations. Delayed contralateral ASDH may manifest as intraoperative brain swelling, postoperative neurological deterioration, or intractably elevated intracranial pressure (ICP).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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“…[5][6][7] One potential devastating complication following DC is the development of an epidural hematoma remote to the craniectomy. 6,[8][9][10][11][12][13] This hematoma has been termed a delayed epidural hematoma (DEDH), as it is often first detected on the postoperative CT imaging studies. However, the hematoma may evolve during the decompression and present intraoperatively with external cerebral herniation through the craniectomy defect.…”

mentioning

confidence: 99%