J Korean Neurosurg Soc.  2013 Feb;53(2):108-111. 10.3340/jkns.2013.53.2.108.

Intracerebral Hemorrhage Following Evacuation of a Chronic Subdural Hematoma

• Kim JK
• Kim SW
• Kim SH

• KMID: 2190687
• DOI: http://doi.org/10.3340/jkns.2013.53.2.108

Abstract

Burr hole drainage has been widely used to treat chronic subdural hematomas (SDH), and most of them are easily treated by simple trephination and drainage. However, various complications, such as, hematoma recurrence, infection, seizure, cerebral edema, tension pneumocephalus and failure of the brain to expand due to cerebro-cranial disproportion may develop after chronic SDH drainage. Among them, intracerebral hemorrhage after evacuation of a recurrent chronic SDH is very rare. Here, we report a fatal case of delayed intracerebral hemorrhage caused by coagulopathy following evacuation of a chronic SDH. Possible pathogenic mechanisms of this unfavorable complication are discussed and a review of pertinent literature is included.

Keyword

Chronic subdural hematoma; Complication; Intracerebral hemorrhage

MeSH Terms

Brain
Brain Edema
Cerebral Hemorrhage
Drainage
Hematoma
Hematoma, Subdural, Chronic
Pneumocephalus
Recurrence
Seizures

Figure

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  Fig. 1 Preoperative computed tomography scan reveals isodense right chronic subdural hematoma with midline shifting.

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  Fig. 2 Postoperative computed tomography scan performed at the next day after trephination shows resolution of hematoma without midline shifting.

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  Fig. 3 Computed tomography scans taken 3 days after initial surgery reveal recurred SDH.

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  Fig. 4 Computed tomography scan performed at the following day after revision surgery shows complete resolution of hematoma without midline shifting.

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  Fig. 5 Postoperative computed tomography images taken on 5 days after revision surgery reveal intracerebral hemorrhage in right basal ganglia and subdural hematoma in right frontoparietal area.

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