Delayed post-operative contralateral epidural hematoma in a patient with right-sided acute subdural hematoma: a case report

Saberi, Hooshang; Meybodi, Ali Tayebi; Meybodi, Keyvan Tayebi; Habibi, Zohreh; Mirsadeghi, Sayed Mohammad Haji

doi:10.4076/1757-1626-2-6282

Cited by 20 publications

(37 citation statements)

References 11 publications

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“…Moreover, the development of a contralateral hematoma at the evacuation site of an acute SDH or EDH is also rare 7). Authors have reported various incidence rates (very rare to 5.7%) of contralateral hematoma after evacuating an ipsilateral hematoma 2681014). In our study, the initial diagnoses of the patients were six (50%) SDH, four (33.3%) EDH, and two (16.7%) CH.…”

Section: Discussionmentioning

confidence: 55%

“…However, many neurosurgeons have experienced such cases. Several neurosurgical procedures are associated with the incidence of contralateral hematoma, including evacuating an acute or chronic SDH and inserting a ventriculo-peritoneal shunt 10). Moreover, the development of a contralateral hematoma at the evacuation site of an acute SDH or EDH is also rare 7).…”

Section: Discussionmentioning

confidence: 99%

“…Contralateral hematoma after decompressive surgery for acute traumatic brain injury, where the brain is usually tense, is uncommon 2781014). Delayed hematoma, contralateral hematoma, alternating hematomas, or bilateral hematomas are other terms used to describe this entity 7).…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Contralateral Hematoma in Patient with Acute Traumatic Brain Injury

Jeong

Shin

et al. 2017

Korean J Neurotrauma

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ObjectiveHead injury is a leading cause of death and disability in subjects who suffer a traumatic accident. Contralateral hematomas after surgery for traumatic brain injury are rare. However, an unrecognized, these hematomas can cause devastating results. We presented our experience of these patients and discussed diagnosis and management.MethodsThis study included 12 traumatic patients with acute traumatic brain injury who developed delayed contralateral hematoma after evacuation of an acute hematoma. Clinical and radiographic data was obtained through review of medical records and radiographs retrospectively.ResultsTen males and two females were included in the study. Ten (83.3%) patients had severe head injury (Glasgow Coma Scale [GCS] score <8). Intraoperative brain swelling during removal of the traumatic subdural hematoma was noted in 10 (83.3%) patients. A skull fracture on the side contralateral to the acute hematoma was noted on computed tomography (CT) scans of nine (75%) patients. Three (33.3%) patients with severe head injury (GCS <8) died. Only (10%) one patient with a severe head injury had less severe disability.ConclusionA postoperative CT scan is essential in patients with acute traumatic brain injury and a contralateral skull fracture or a low GCS score. Our results indicated that it is very important to evaluate this rare but potentially devastating complication.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Postoperative Contralateral Hematoma in Patient with Acute Traumatic Brain Injury

Jeong

Shin

et al. 2017

Korean J Neurotrauma

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“…The cases included 81% contralateral skull fractures and 76% intraoperative acute brain swelling. 28 Our patient was male, 19 years old and had contralateral skull fractures.…”

Section: Discussionmentioning

confidence: 89%

“…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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Surgery for contralateral acute epidural hematoma following acute subdural hematoma evacuation: five new cases and a short literature review

et al. 2012

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Lower preoperative GCS score is an independent risk factor for prognosis of contralateral AEDH after ASDH. Postoperative management should include assessment of AEDH in patients treated for contralateral skull fractures and who experienced intraoperative acute brain swelling. We recommend early decompression with a burr-hole craniotomy, immediately followed by a decompressive craniectomy. This strategy provides gradual decompression, while advancing the initial surgical time and preventing the suddle decreased tamponade effect. As such, it may help decrease the risk of contralateral AEDH associated with decompression.

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Delayed post-operative contralateral epidural hematoma in a patient with right-sided acute subdural hematoma: a case report

Cited by 20 publications

References 11 publications

Postoperative Contralateral Hematoma in Patient with Acute Traumatic Brain Injury

Postoperative Contralateral Hematoma in Patient with Acute Traumatic Brain Injury

Epidural hematoma: postoperative complication

Surgery for contralateral acute epidural hematoma following acute subdural hematoma evacuation: five new cases and a short literature review

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