Korean J Neurotrauma.  2017 Oct;13(2):149-152. 10.13004/kjnt.2017.13.2.149.

Postoperative Subarachnoid Hemorrhage and Multipunctate Intracerebral Hemorrhages Following Evacuation of Bilateral Chronic Subdural Hematomas

Affiliations
  • 1Department of Neurosurgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea. ktokhou@gmail.com

Abstract

Chronic subdural hematoma (CSDH) can be easily treated by burr hole surgery. However, several complications including intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and acute subdural hematoma are rare after evacuation of a CSDH. A 77-year-old man was admitted with right hemiparesis and dysarthria. A brain computed tomography (CT) scan revealed a bilateral CSDH with midline shifting toward the right side. The patient got the burr hole trephination with the catheters insertion in the both sides of parietal area under the local anesthesia. After burr hole surgery immediately, he developed left side weakness and decreased level of consciousness. Repeat CT scans detected a diffuse SAH and multiple small ICHs. He was treated conservatively and fully recovered at discharge after 1 month. To avoid these complications, slow and gradual drainage of the CSDH is needed. The authors report a rare case of SAH and multipunctate ICHs in both cerebral hemispheres after evacuation of a bilateral CSDH.

Keyword

Chronic subdural hematoma; Drainage; Intracerebral hemorrhage; Subarachnoid hemorrhage

MeSH Terms

Aged
Anesthesia, Local
Brain
Catheters
Cerebral Hemorrhage*
Cerebrum
Consciousness
Drainage
Dysarthria
Hematoma, Subdural, Acute
Hematoma, Subdural, Chronic*
Humans
Paresis
Rabeprazole
Subarachnoid Hemorrhage*
Tomography, X-Ray Computed
Trephining
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