Intracerebral haemorrhage during surgery for chronic subdural haematoma

Satõ, Mitsuo; Nakano, Masayuki; Asari, Jun; Watanabe, Kazuo

doi:10.1016/j.jocn.2005.12.044

Cited by 13 publications

(11 citation statements)

References 16 publications

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“…Physiological aging of the cerebral vascular tree is associated with poor tolerance of sudden variations in cerebral blood flow. 20) Considering that the present patient was elderly, the increased fragility of the small blood vessels might not have been able to sustain the rapid changes in the brain stem blood flow during decompression of the subdural hematoma. Consequently, the brain stem hemorrhage in the present case was likely due to the mechanical disruption of small fragile vessels caused by transient aggravation of the transtentorial herniation during the first decompression procedure, and accentuated by an increase in blood flow caused by breakthrough-like dysregulation triggered by the abrupt supratentorial decompression.…”

Section: Discussionmentioning

confidence: 86%

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

Park

Kang

Lee

et al. 2009

Neurol. Med. Chir.(Tokyo)

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A 76-year-old man presented with brain stem hemorrhage after burr-hole drainage for bilateral chronic subdural hematomas. Neuroimaging demonstrated resolution of the transtentorial herniation but also detected new brain stem hemorrhage, manifesting as gait disturbance. He recovered after conservative treatment. Asymmetrical and rapid decompression, which leads to vascular disruption and/or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem hemorrhage. Therefore, simultaneous and bilateral decompression with a slow rate of evacuation of massive bilateral chronic subdural hematomas is recommended to prevent serious complications such as secondary intracranial hematoma.

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Section: Discussionmentioning

confidence: 86%

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

Park

Kang

Lee

et al. 2009

Neurol. Med. Chir.(Tokyo)

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“…Single photon emission computed tomography has demonstrated that cerebral blood flow in patients with CSDHs is diminished, particularly in the ipsilateral basal ganglia and thalamus (2,3), followed postoperatively by progressive normalization of blood flow. Physiological aging of the cerebral vascular tree is associated with poor tolerance of sudden variations in cerebral blood flow (15). Considering that the present patient was elderly, the increased fragility of the small blood vessels might not have been able to sustain the rapid changes in the brain stem blood flow during decompression of the subdural hematoma.…”

Section: Discussionmentioning

confidence: 88%

A Rare Complication of Chronic Subdural Hematoma Evacuation: Brain Stem Hemorrhage: A Case Report

Gader¹,

Rkhami²,

Salem³

et al. 2018

Romanian Neurosurgery

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Chronic subdural hematoma (CSDH), which commonly affects the elderly, is one of the most frequent, but also benign neurosurgical pathologies. Burr hole drainage is the standard surgical modality for evacuation of a CSDH. This technique is known to be safe, with low morbidity and mortality rates. However, postoperative complications have occasionally been reported. We report the case of a 70-year-old man who presented a fatal brain stem hemorrhage after burr-hole drainage for unilateral chronic subdural hematoma. Asymmetrical and rapid decompression were thought to be leading to vascular disruption or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem bleeding. Therefore, a slow rate of evacuation of chronic subdural hematomas, as well as rigorous postoperative reanimation, are recommended in order to prevent serious complications.

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“…There were no complications such as infection, subdural empyemas, acute intracerebral or cerebellar hemorrhage, and postoperative epilepsy. 2,16,22) Symptomatic …”

Section: Resultsmentioning

confidence: 99%

Critical Classification of Craniostomy for Chronic Subdural Hematoma; Safer Technique for Hematoma Aspiration

Tosaka

Sakamoto²,

Watanabe³

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Chronic subdural hematoma (CSDH) is generally treated by twist drill, and one and two burr-hole craniostomy. We proposed new classification of the intraoperative condition of CSDH, and present a safer technique for aspiration of CSDH in one burr-hole surgery. The intraoperative condition of CSDH was classified according to the connections between the hematoma cavity and the extracranial space as follows. The``closed condition'' represents only a single route consisting of a tube inserted intraoperatively connecting the extracranial space to the hematoma cavity. The``open condition'' includes another route or space, which can freely pass air, saline, or old hematoma fluid, in addition to the tube inserted intraoperatively. Twist drill craniostomy and two burr-hole craniostomy clearly involve the intraoperative closed and open conditions, respectively. One burr-hole craniostomy may involve either condition due to the operative procedure. Aspiration and irrigation of the hematoma is basically free and safe in the open condition, but risky in the closed condition. All of the hematoma can be aspirated through one burr hole under certain open conditions with temporary replacement of the hematoma cavity with air followed by replacement of air with saline. Twenty-seven patients with symptomatic CSDH underwent one burr-hole craniostomy by the above mentioned aspiration technique. There were no special complications. The recurrence rate was average. The substitution of saline after complete aspiration of hematoma carries little risk only under the``open condition,'' shortens the operation time, and achieves good irrigation of the hematoma.

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Intracerebral haemorrhage during surgery for chronic subdural haematoma

Cited by 13 publications

References 16 publications

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

Brain Stem Hemorrhage Following Burr Hole Drainage for Chronic Subdural Hematoma -Case Report-

A Rare Complication of Chronic Subdural Hematoma Evacuation: Brain Stem Hemorrhage: A Case Report

Critical Classification of Craniostomy for Chronic Subdural Hematoma; Safer Technique for Hematoma Aspiration

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