Spontaneous subdural hematoma as a rare complication of neuraxial anaesthesia

Abstract 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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Polymicrobial Skull Osteomyelitis: A Rare Complication of Subdural Hematoma Evacuation

Surgical Infections ◽

10.1089/sur.2005.060 ◽

2007 ◽

Vol 8 (4) ◽

pp. 483-490 ◽

Cited By ~ 4

Author(s):

Scott W. Calcagno ◽

Richard M. Graves ◽

Sue E. Baum ◽

Richard J. Teff

Keyword(s):

Subdural Hematoma ◽

Rare Complication ◽

Hematoma Evacuation

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Subdural Hematoma Following Spinal Cord Stimulator Implant

January 2018 - Pain Physician ◽

10.36076/ppj.2008/11/97 ◽

2008 ◽

Vol 1;11 (1;1) ◽

pp. 97-101

Author(s):

Srinivas Chiravuri

Keyword(s):

Spinal Cord ◽

Subdural Hematoma ◽

Dural Puncture ◽

Rare Complication ◽

Delayed Diagnosis ◽

Secondary Process ◽

Spinal Cord Stimulator ◽

Diagnostic Challenge ◽

Treatment Change ◽

Presenting Symptoms

Headache following interventional procedures is a diagnostic challenge due to the multitude of possible etiologies involved. Presentation can be simple (PDPH alone) or complex (exacerbation of pre-existing chronic headache along with PDPH) or headache associated with a new onset intracranial process. Subdural hematoma is a rare complication of cranio-spinal trauma. Cranial subdural hematoma may present in an acute, sub-acute, or chronic fashion. Diagnosis of a subdural hematoma in the wake of a PDPH is difficult, requiring a high level of suspicion. Delayed diagnosis of subdural hematoma is usually related to failure to consider it in the differential diagnosis. Thorough history, assessment of the evolution of symptoms, and imaging studies may identify the possible cause and help direct treatment. Change in the character of initial presenting symptoms may be a sign of resolution of the headache or the onset of a secondary process. We report a case of acute intracranial subdural hematoma secondary to unintentional dural puncture during placement of a permanent spinal cord stimulator lead for refractory angina. There is need for careful follow-up of patients with a known post-dural tear. Failure to identify uncommon adverse events in patients with complicated spinal cord stimulator implantation may lead to permanent injury. Key words: Subdural, post-dural puncture, headache, spinal cord stimulation

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Spinal subdural hematoma post foramen magnum decompression—rare complication in a patient with rhomboencephalosynapsis

Journal of Spine Surgery ◽

10.21037/jss.2017.11.02 ◽

2017 ◽

Vol 3 (4) ◽

pp. 719-722

Author(s):

Kapil Mohan Rajwani ◽

Anastasios Giamouriadis ◽

Pawanjit Singh Minhas

Keyword(s):

Subdural Hematoma ◽

Rare Complication ◽

Foramen Magnum ◽

Foramen Magnum Decompression ◽

Spinal Subdural Hematoma

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Cortical herniation through compressive subdural membrane in an infant with a history of a large bihemispheric subdural hematoma and subdural-peritoneal shunt: case report

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.8.peds16108 ◽

2017 ◽

Vol 19 (2) ◽

pp. 168-173 ◽

Cited By ~ 1

Author(s):

Aleka Scoco ◽

E. Emily Bennett ◽

Violette Recinos

Keyword(s):

Case Report ◽

Subdural Hematoma ◽

Rare Complication ◽

Unique Case ◽

Membrane Formation ◽

History Of ◽

Fluid Collections

Cortical herniation through subdural membrane formation is a rare complication of chronic subdural fluid collections and may occur following subdural shunting. The authors present a unique case of progressive cortical herniation through a compressive subdural membrane that occurred concomitant with a functioning subdural-peritoneal shunt.

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Subdural hematoma – a rare complication of removal of osseointegrated auricular prosthesis retention system

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2014.05.016 ◽

2014 ◽

Vol 78 (8) ◽

pp. 1413-1415 ◽

Cited By ~ 3

Author(s):

Brent G. Nichols ◽

Sean M. Lew ◽

Joseph E. Kerschner

Keyword(s):

Subdural Hematoma ◽

Rare Complication ◽

Prosthesis Retention ◽

Retention System

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Risk Factors for Acute Subdural Hematoma From Intracranial Aneurysm Rupture

Neurosurgery ◽

10.1227/neu.0b013e318256c27d ◽

2012 ◽

Vol 71 (2) ◽

pp. 264-269 ◽

Cited By ~ 16

Author(s):

J. Matthijs Biesbroek ◽

Gabriel J.E. Rinkel ◽

Ale Algra ◽

Jan Willem Berkelbach van der Sprenkel

Keyword(s):

Risk Factors ◽

Intracranial Aneurysm ◽

Subdural Hematoma ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Rare Complication ◽

Aneurysm Rupture ◽

Posterior Communicating Artery ◽

Acute Subdural Hematoma ◽

Vertebral Aneurysm ◽

Risk Ratios

Abstract BACKGROUND: An acute subdural hematoma (aSDH) is a rare complication of aneurysmal subarachnoid hemorrhage (SAH) and is associated with poor clinical condition on admission and poor outcome. Risk factors for the development of an aSDH from aneurysmal rupture are unknown and may help our understanding of how an aSDH develops. OBJECTIVE: To identify risk factors for the development of an aSDH from intracranial aneurysm rupture. METHODS: Patients were selected from our prospectively collected single-center SAH database. From all 1757 patients fulfilling prespecified inclusion criteria, 63 had an aSDH. We assessed sex, age, smoking, hypertension, history of SAH, sentinel headache, location of the ruptured aneurysm, and intracerebral hemorrhage (ICH) as risk factors for an aSDH. Univariable and multivariable risk ratios with corresponding 95% confidence intervals (CIs) were calculated for characteristics with Poisson regression. RESULTS: Multivariable risk ratios were 1.021 (95% CI: 1.001-1.042) for each year increase in age, 2.3 (95% CI: 1.3-3.8) for posterior communicating artery aneurysms, 3.0 (95% CI: 1.5-6.0) for sentinel headache, and 5.2 (95% CI: 3.1-8.9) for ICH. None of the 95 patients (0%; 95% CI: 0%-3.8%) with a ruptured vertebrobasilar aneurysm had an aSDH, which was statistically significantly lower than at other sites (P = .02 for basilar aneurysm; P = .04 for vertebral aneurysm). None of the other studied characteristics had a statistically significant association with an aSDH. CONCLUSION: Increasing age, sentinel headache, ICH, and aneurysms at the posterior communicating artery are independent risk factors for an aSDH. Patients with a basilar or vertebral aneurysm have a low risk of an aSDH.

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Bilateral Chronic Subdural Hematoma and Blindness: Bilateral Infarction to the Posterior Cerebral Artery following Evacuation of Bilateral Chronic Subdural Hematoma — A Rare Case Report and Review of Literature

Indian Journal of Neurotrauma ◽

10.1055/s-0037-1604052 ◽

2017 ◽

Vol 14 (01) ◽

pp. 046-052

Author(s):

Sendilkumar Adimoolam ◽

Syamala Shunmugam ◽

Sneha Balasubramanian

Keyword(s):

Subdural Hematoma ◽

Past History ◽

Rare Complication ◽

Chronic Subdural Hematoma ◽

Vascular Abnormality ◽

Rare Case Report ◽

History Of ◽

Burr Holes ◽

Bilateral Chronic Subdural Hematoma ◽

Ct And Mri

Objective The authors report a rare scenario in which evacuation of bilateral chronic subdural hematoma (CSDH) was followed by bilateral PCA infarction and blindness. A literature review was also conducted, which revealed only four cases of blindness after CSDH evacuation. Methods A 45-year-old man was admitted with the chief complaint of holocranial headache for 2 months with past history of head trauma. Clinical examination was normal. CT and MRI scanning showed bilateral frontotemperoparietal CSDH without midline shift and parenchymal and vascular abnormality. Bilateral frontal and parietal burr holes and evacuation of CSDH was done. Results The patient developed progressive blindness in both the eyes in the postoperative period. MRI revealed bilateral PCA infarction. Discussion Bilateral PCA infarction following bilateral CSDH evacuation is an extremely rare entity. Only four case of blindness following CSDH evacuation have been reported so far, and all the patients suffered permanent visual loss. The exact etiopathogenesis and mechanism of this rare complication remain unknown. Conclusion Bilateral CSDH is a separate entity with altered pathophysiology and deranged cerebral autoregulation. The authors conclude that Bilateral CSDH may be sentinel tags for bilateral PCA infarction secondary to altered hemodynamics in the posterior circulation, and hence, needs to be evaluated and treated with greater diligence.

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Brain Abscess Complicating a Traumatic Intracerebral Hemorrhagic Contusion

The Neurohospitalist ◽

10.1177/1941874420985992 ◽

2021 ◽

pp. 194187442098599

Author(s):

Earllondra Brooks ◽

Lauren Kett ◽

Joshua P. Klein

Keyword(s):

Subarachnoid Hemorrhage ◽

Intracerebral Hemorrhage ◽

Brain Abscess ◽

Temporal Lobe ◽

Intracranial Hemorrhage ◽

Subdural Hematoma ◽

Mr Spectroscopy ◽

Complete Resolution ◽

Rare Complication ◽

Imaging Studies

A 63-year-old right-handed man was admitted to our hospital after sustaining a traumatic right-sided subdural hematoma, subarachnoid hemorrhage, and temporal lobe hemorrhagic contusion. He was managed non-operatively and discharged without any neurologic deficits. Two weeks later he presented with worsening headaches and altered sensorium. Imaging studies showed that the patient had developed a cerebral abscess at the site of his intracerebral hemorrhage. The abscess was surgically resected, and the patient was treated with antibiotics with complete resolution of symptoms. This case illustrates the importance of timely recognition of a rare complication of intracranial hemorrhage, and the utility of MR spectroscopy.

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