Traumatic and alternating delayed intracranial hematomas

Abstract

Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma.

Stroke Complicating Percutaneous Coronary Interventions

“…17 In addition, delayed subdural hematoma may follow recovery from peripheral vascular collapse. 18 Hence, the risk associated with use of IABP in our patients may merely reflect periprocedural hemodynamic impairment and not be causative. Additional possible mechanisms include increased risk of hemorrhagic stroke secondary to more intense and prolonged anticoagulation in patients necessitating IABP.…”

Decompressive surgery for acute subdural haematoma leading to contralateral extradural haematoma: a report of two casesand review of literature

“…14 Development of extradural haematoma contralateral to the site of evacuation of acute subdural haematoma or extradural haematoma is rare. Only 26 such cases [1][2][3][4][5][6][7][8][9][10][11][12] have been reported in English language literature up to March 2005 (Table I). One case of delayed contralateral EDH, detected at autopsy has also been reported.…”

“…The main cause, therefore, appears to be the upsetting of the equilibrium between damaged vessels and the reactive intracranial pressure. 3 Surgical evacuation of the first haematoma played a role comparable with that of tamponade: the drop in the intracranial pressure enabled the vessels initially damaged on the contralateral hemisphere to bleed. 3 Low intracranial pressure, high blood pressure or rapid correction of hypotension, acting concurrently or in isolation, favour the production of an extradural haematoma, especially at areas already injured such as under skull fracture.…”

“…3 Surgical evacuation of the first haematoma played a role comparable with that of tamponade: the drop in the intracranial pressure enabled the vessels initially damaged on the contralateral hemisphere to bleed. 3 Low intracranial pressure, high blood pressure or rapid correction of hypotension, acting concurrently or in isolation, favour the production of an extradural haematoma, especially at areas already injured such as under skull fracture. 1 -4 Low intracranial pressure may cause intracranial bleeding by itself, without trauma, as in cases of extracerebral haemorrhage complicating shunt surgery, ventriculography, ventricular and subarachnoid drainage, spinal anaesthesia, and posterior fossa and spinal intradural operations.…”

“…1 -12 Delayed haematoma, contralateral haematoma, alternating haematomas or bilateral haematomas are the other terms used to describe this entity. 3,5,7 The formation of extradural haematoma following trauma is common. Even extradural haematoma contralateral to the site of injury is known.…”