Spontaneous epidural hematoma following a shunt in an infant with congenital factor X deficiency

Fujimoto, Yasunori; Aguiar, Paulo Henrique Pires de; Carneiro, Jorge David Aivazoglou; Martins, Roberto S.; Ciquini, Orildo

doi:10.1007/s101430050022

Cited by 20 publications

(14 citation statements)

References 37 publications

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“…As a complication of surgery, AEH occurs mostly at craniotomy sites, with possible extension under the adjacent bone due to mechanical distension of the dura away from the skull. Extradural haematomas remote from the site of surgery, as in our case was more rare [8, 9]. …”

Section: Discussionmentioning

confidence: 90%

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Paiva

Oliveira

Andrade

et al. 2010

Case Reports in Medicine

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Objective. Subdural hygroma is reported to occur in 5%–20% of all patients with closed head trauma, the treatment is controversial and in symptomatic cases surgical drainage is need. We report on a new case with remote acute epidural hematoma (AEH) after subdural hygroma drainage. Case Presentation. A 38-year-old man suffered blunt head trauma and had diffuse axonal injury grade III in CT scan. A CT scan that was late performed showed an increasing subdural fluid collection with mild mass effect and some effacement of the left lateral ventricle. We perform a trepanation with drainage of a hypertensive subdural collection with citrine aspect. Postoperative tomography demonstrated a large left AEH. Craniotomy and evacuation of the hematoma were performed. Conclusion. The mechanism of remote postoperative AEH formation is unclear. Complete reliance on neurologic monitoring, trust in an early CT scan, and a relative complacency after an apparently successful initial surgery for hygroma drainage may delay the diagnosis of this postoperative AEH.

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Section: Discussionmentioning

confidence: 90%

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Paiva

Oliveira

Andrade

et al. 2010

Case Reports in Medicine

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“…Evacuation of a mass lesion can rarely result in the development of a contralateral extra-axial hematoma, most often in the subdural space. Epidural hemorrhage, although rare, has been reported following shunting for hydrocephalus [6,29]. It is unclear, however, if evacuation and decompression contribute significantly to hemorrhage in a patient with a demonstrated propensity for spontaneous epidural bleeding.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous epidural hemorrhage in chronic renal failure

et al. 2004

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Spontaneous epidural hemorrhage has been described in a variety of clinical scenarios, including chronic renal failure (CRF). During hemodialysis, patients with CRF rarely develop spinal or cranial epidural hematomas. Such hemorrhages have been attributed to intracranial pressure fluctuations during hemodialysis, heparin administration, uremic-platelet syndrome, or hypertension. Although the exact pathophysiology is not understood, this rare consequence of hemodialysis has been well documented in the literature. Hemorrhage in the absence of hemodialysis therapy in a CRF patient, however, has not been previously reported. We report a 16-year-old boy with no history of trauma who woke in the morning with severe headache and resultant neurological deterioration. He was found to have a large left temperoparietal epidural hematoma and underwent urgent surgical evacuation. Postoperatively he developed a contralateral extra-axial hematoma that did not require surgical intervention. He recovered completely, with no significant neurological deficit. This unique presentation of spontaneous intracranial epidural hemorrhage in an adolescent not receiving hemodialysis highlights a rare, but serious, complication of CRF.

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“…6,14 Fujimoto et al reported prone surgery position as a further risk factor for EDH. 15 Present patient's single risk factor was his age. Age is important because dural-calvarial adhesions The frontal and parietal lobes are the most common sites of EDH.…”

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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Spontaneous epidural hematoma following a shunt in an infant with congenital factor X deficiency

Cited by 20 publications

References 37 publications

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Remote Postoperative Epidural Hematoma after Subdural Hygroma Drainage

Spontaneous epidural hemorrhage in chronic renal failure

Epidural hematoma: postoperative complication

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