Postoperative hematoma involving brainstem, peduncles, cerebellum, deep subcortical white matter, cerebral hemispheres following chronic subdural hematoma evacuation

Patibandla, Mohana Rao; Thotakura, Amit Kumar; Shukla, D. K.; Purohit, A K; Addagada, Gokul Chowdary; Nukavarapu, Manisha

doi:10.4103/1793-5482.144163

Cited by 8 publications

(7 citation statements)

References 20 publications

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“…All included studies were meticulously reviewed and scrutinized for their study design, methodology, and patient characteristics. Patient data were recorded when available, including age, sex, coexisting factors, use of anticoagulants/antiplatelets, cSDH side, symptoms after burr hole cSDH drainage, RICH location, time course of neurologic deterioration, treatment, and outcome ( Table 1 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ). Our case was not included in this systematic review.…”

Section: Methodsmentioning

confidence: 99%

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

Umana

Salvati

Fricia

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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Background Remote intracerebral hemorrhage (RICH) is a severe complication following chronic subdural hematoma (cSDH) drainage, and only case reports and small case series have been reported to date. The authors present an emblematic patient affected by RICH following cSDH drainage. A systematic review of the literature on diagnosis and management of patients affected by RICH following cSDH evacuation has also been performed. Methods A literature search according to the PRISMA statement was conducted using PubMed and Scopus databases with the following Mesh terms: [(remote) AND (intracerebral hemorrhage or cerebral hematoma or cerebral infarction or cerebellar hemorrhage or cerebellar hematoma or cerebellar infarction) AND (chronic subdural hematoma)]. Results The literature search yielded 35 results, and 25 articles met our inclusion criteria: 22 articles were case reports and 3 were case series including three to six patients. Overall, 37 patients were included in the study. Age was reported in all 37 patients, 26 males (70.3%) and 11 females (29.7%), with a male-to-female ratio of 2.4:1. The mean age at diagnosis was 64.6 years (range: 0.25–86 years). Only in 5 cases (13.5%) did the ICH occur contralaterally to the previously drained cSDH. The rapidity of drainage can lead to several types of intracranial hemorrhages, caused by a too rapid change in the cerebral blood flow (CBF) and/or tears of bridging veins. The average time interval between cSDH drainage and neurologic deterioration was 71.05 hours (range: 0–192 hours). Conclusions RICH following cSDH represents a rare occurrence and a serious complication, associated with elevated morbidity. Careful monitoring of drain speed after cSDH evacuation surgery is recommended, and minimally invasive techniques such as twist drill craniostomy are suggested, especially for massive cSDHs.

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Section: Methodsmentioning

confidence: 99%

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

Umana

Salvati

Fricia

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

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“…To the best of our knowledge, only four cases of brain stem hemorrhage as a complication of surgery for CSDH have been reported (8,(10)(11)(12). Two cases were diagnosed at autopsy, two at postoperative control CT scan.…”

Section: Discussionmentioning

confidence: 98%

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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“…CSDH is one of the most common neurosurgical pathologies. Complications during the postoperative period, including failure of the brain to re-expand, recurrence of hematoma and tension pneumocephalus, are associated with a poor prognosis [ 1 ]. Postoperative hemorrhagic complications, such as intracerebral hematoma, acute subdural hematoma or SAH, are rare but severe.…”

Section: Discussionmentioning

confidence: 99%

“…A chronic subdural hematoma (CSDH) can be treated by a relatively simple burr hole surgery, which exhibits a mortality rate of 0.5–4.0%. Elderly individuals and alcoholics are commonly affected by CSDH [ [1] , [2] ]. A CSDH might be found incidentally on brain imaging.…”

Section: Introductionmentioning

confidence: 99%

Remote acute subarachnoid hemorrhage after drainage of chronic subdural hematoma: A case report and review of the literature

Wang

2018

International Journal of Surgery Case Reports

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HighlightsChronic subdural hematoma (CSDH) can be treated by a relatively simple burr hole surgery. Acute subarachnoid hemorrhage (SAH) occurring after surgery for CSDH has been reported as a rare but severe complication. So, we reported this case.Acute SAH occurring after surgery for CSDH is a rare but severe complication associated with the postoperative drainage speed. Rapid variation of cerebral blood flow and perioperative parenchymal shift occur due to the speed of the drainage system. Thus, the height of the tube should not be too low, thereby avoiding“too rapid or too excessive postoperative drainage.”Slow decompression with closed-system drainage is recommended to avoid rapid dynamic intracranial changes during drainage of a subdural hematoma, including brain shift or restoration of normal perfusion, to prevent devastating complications.

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Postoperative hematoma involving brainstem, peduncles, cerebellum, deep subcortical white matter, cerebral hemispheres following chronic subdural hematoma evacuation

Cited by 8 publications

References 20 publications

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

A Review of Remote Intracerebral Hemorrhage after Chronic Subdural Hematoma Evacuation

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

Remote acute subarachnoid hemorrhage after drainage of chronic subdural hematoma: A case report and review of the literature

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