Akut subdural hematom cerrahisi sonrası postoperatif kontralateral epidural hematom ve ipsilateral intraserebral hematom

Year 2015, Volume: 5 Issue: 1, 0 - 0, 27.02.2015

Ezgi Akar , Mehmet Ufuk Akmil , Mehmet Zafer Berkman Metin Orakdöğen

Abstract

Kraniotomi sonrası uzak bir alanda intrakranial hemoraji gelişmesi nadir bir durumdur. Literatür tarandığında yaklaşık 40 adet lezyonun zıt tarafında gelişen epidural hematom vakası bulundu, fakat operasyon sahasına komşu intraserebral hematom ile birlikte olan vaka görülmedi. Postoperatif altıncı günde subdural hematom ile aynı tarafta temporoparietal intraserebral hematom gelişti. İntraserebral hematom konservatif olarak takip edildi. Biz bu sunuda; subdural hematom boşaltılması sonrası karşı tarafta gelişen epidural hematoma cerrahi yaptığımız, takiplerde ipsilateral intraserebral hematom gelişen vakamızı sunduk.

Postoperative contrecoup acute epidural hematoma and ipsilateral intracerebral hematoma following acute subdural hematoma surgery

Abstract

Development of intracranial hemorrhage at a distant area is a rare complication after craniotomy. When the literature has been scanned, approximately 40 cases of contrecoup epidural hematoma were found, but case with intracerebral hematoma developed adjacent to operation area was not observed. We presented our case that we performed surgery for contrecoup acute epidural hematoma following subdural hematoma evacuation and we followed up the ipsilateral intraparenchymal hematoma developed after the surgery. Our case was a 27 year old male patient brought to the emergency room after the traffic accident. On the computerized tomography (CT) left frontotemporoparietal acute subdural hematoma was observed and the hematoma was evacuated by the decompressive craniectomy. Contralateral frontotemporoparietal epidural hematoma was observed on the CT of the patient in whom anisocoria was seen in postoperative second hour and hematoma was evacuated by craniotomy. Temporoparietal intracerebral hematoma was developed on the side of subdural hematoma on the postoperative sixth day. Intracerebral hematoma was followed up as an conservatively.

References

• Tetsuryu M, Mitsunobu I, Hirotsune K. Acute epidural hematoma caused by contrecoup head ınjury. Neurol Med Chir (Tokyo) 2004;44: 584-586.
• Fridley J, Thomas J, Kitagawa R, Chern J, Omeis I. Immediate development of a contralateral acute subdural hematoma evacuation. J Clin Neurosci 2011;18: 422-423.
• Harada K, Ohtsuru K, Nakayama K, Takagi S, Shigemori M, Tokunaga T et al. Contralateral development of acute subdural hematoma following surgery for chronic subdural hematoma-case report. Neurol Med Chir (Tokyo) 1992;32: 969-971.
• J Jian S, Zuoxu F, Tao J, Jianwei P, Yongqing Z, Renya Z. Contralateral acute subdural hematoma following traumatic acute subdural hematoma evacuation. Neurol Med Chir (Tokyo) 2013;53: 221-224.
• Gennarelli TA, Meaney DF. Mechanism of primary head injury, in Wilkins RH, Rengachary SS (eds): Neurosurgery New York, McGraw-Hill, 1996, pp 2611-2621.
• Modesti LM, Hodge CJ, Barnwell ML. Intracerebral hematoma after evacuation of chronic extracerebral fluid collections. Neurosurgery 1982;10: 689-693.
• Moon KS, Lee JK, Kim TS, Jung S, Kim JH, Kim SH et al. Contralateral acute subdural hematoma occuring after removal of calcified chronic subdural hematoma. J Clin Neurosci 1997;14: 283-286.
• Su TM, Shih TY, Yen HL, Tsai YD. Contralateral acute subdural hematoma occuring after evacuation of subdural hygroma: case report. J Trauma 2001;50: 557-559.