Severe remote cerebellar hemorrhage with intracerebral hemorrhage after burr-hole evacuation for chronic subdural hematoma

2017 ◽  
Vol 3 (2) ◽  
pp. 90-96
Author(s):  
Hua Yu ◽  
Hua Yu ◽  
Song Tong ◽  
Ahmed Abdelmaksoud ◽  
Fu Peng ◽  
...  
2017 ◽  
Vol 3 (2) ◽  
pp. 90-96
Author(s):  
Hua Yu ◽  
Song Tong ◽  
Ahmed Abdelmaksoud ◽  
Fu Peng ◽  
Huang Tao ◽  
...  

Since remote cerebellar hemorrhage, with intracerebral hemorrhage after supratentorial neurosurgery, is rare, its pathophysiology remains elusive. Here, we report a 64-year-old man who had severe bilateral symmetric remote cerebellar hemorrhage with frontal lobe hemorrhage following burr-hole evacuation for supratentorial chronic subdural hematoma. Computed tomography venography showed undeveloped left internal jugular vein and sigmoid sinus. He received 3 weeks of conservative treatment and fully recovered. Overdrainage of cerebrospinal fluid and head rotation with undeveloped internal jugular vein may have resulted in this complication. This case is the first case in the literature with this event sequence and has some significance for revealing the mechanism of remote cerebellar hemorrhage occurrence after other supratentorial surgeries.


Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 185-188 ◽  
Author(s):  
Thomas Marc Markwalder ◽  
Rolf W. Seiler

Abstract A consecutive series of 21 adult patients with chronic subdural hematoma was studied in respect to postoperative resolution of subdural collections and clinical improvement after burr hole evacuation without subdural drainage. This series was compared to a previously studied series of patients with chronic subdural hematoma in whom postoperative closed system drainage had been installed. Using the identical protocol for treatment and postoperative follow-up, we obtained identical results with respect to time-related neurological improvement and persistence of subdural collections in the undrained and drained series, except that the steadily progressive clinical improvement during the early postoperative phase (24 hours) in all cases of the drained series was not universal in the undrained cases. Our study suggests that, to avoid the possibility of early postoperative clinical deterioration, burr hole craniostomy and closed system drainage is advisable. We think that subdural drainage is not necessary when the installation of the drainage system seems to be technically difficult, as it may be in cases with considerable perioperative cortical expansion.


2014 ◽  
Vol 62 (2) ◽  
pp. 169 ◽  
Author(s):  
Bhaskar Suryanarayanan ◽  
Ajay Choudhary ◽  
LaxmiNarayan Gupta ◽  
Akhila Prasad ◽  
AmitKumar Singh ◽  
...  

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Abebe Mersha ◽  
Sahlu Abat ◽  
Tsegaye Temesgen ◽  
Abebe Nebyou

BACKGROUND: Chronic subdural hematoma (CSDH) is a common condition encountered in daily neurosurgical practice usually affecting the elderly population. Various surgical procedures have been used for the evacuation of hematoma in patients with CSDH. The objective of this paper was to study the postoperative outcome of patients who were operated for CSDH and to describe the easy, safest and effective procedure that can be performed at primary level hospitals.METHODS: Institutional based cross-sectional retrospective study was conducted among patients operated for CSDH from January 1, 2012 to December 31, 2015 at Teklehaymanot General Hospital, a private hospital in Addis Ababa, Ethiopia. Descriptive statistics, using SPSS version 20, was used to determine the postoperative outcomes including hospital stay, complications and recurrence rate.RESULTS: Of the 195 charts reviewed, 70.3% were of males, with M: F ratio of 2.4:1. 68.2% of patients being above the age of 55 years with a mean age at presentation of 57.63. The most common presenting symptom was headache followed by extremity weakness. The diagnosis of CSDH was made with either head CT scan or MRI. Forty one percent of patients had a left side hematoma and 48(24.6%) patients had bilateral CSDH. All patients were operated with a single burr hole evacuation under local anesthesia and postoperative subdural closed system drainage by a single neurosurgeon. The mean hospital stay was 3.68±2.6 days. The postoperative outcome was assessed using the Glasgow Outcome Score, and 95.9% of the patients reported good recovery. Thirteen (6.6%) patients were operated twice for recurrence, and there were four deaths.CONCLUSIONS: Single burr hole craniostomy is an easy, safe and effective technique for the treatment of CSDH.


2012 ◽  
Vol 52 (185) ◽  
Author(s):  
P Shrestha ◽  
B Panta ◽  
P Shrestha ◽  
P Rajbhandari

Introduction: Chronic subdural hematoma (CSDH) may occasionally contain organized hematoma which can lead to recurrence and other complications after surgery. There is no exact study and data about OHTMF in Nepal so far. The main objective of this study is to study its prevalence and complications. Methods: This is a multicentric retrospective analytical study being carried out at Norvic International Hospital and Annapurna Neurological Institute. We retrospectively analyzed one hundred cases of CSDH between early 2006 to 2010 August. We focused our study mainly on OHTMF. Results: Of 100 cases, majority of the patients were male ranging from 4 to 85 years of age. Bilateral subdural hematoma was found in about 9% of cases. Majority of cases were treated in usual fashion with single burr hole and drain. OHTMF was found in 3 cases (3%) for which craniotomy with radical membranectomy was performed. In 2 cases membrane formation was noticed during surgery, craniotomy with total membranectomy was performed immediately. In one case there was recurrence of CSDH within 10 days of single burr hole evacuation. Craniotomy with membranectomy was performed in 2nd surgery. There was no recurrence after membranectomy. One case developed seizure post operatively. Conclusions: OHTMF is one of the important causes of CSDH recurrence. It has to be treated radically. Different hypthotheses have been postulated regarding thick membrane formation in CSDH. We have tried to discuss these hypotheses. Keywords: burr hole evacuation, craniotomy, CSDH, OHTMF.


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