Surgery for contralateral acute epidural hematoma following acute subdural hematoma evacuation: five new cases and a short literature review

Autor: Ren Ya Zhan, Yong Qing Zhou, Jian Shen, Jianwei Pan, Zuo Xu Fan, Zhe Chen
Rok vydání: 2012
Předmět:
Zdroj: Acta Neurochirurgica. 155:335-341
ISSN: 0942-0940
0001-6268
DOI: 10.1007/s00701-012-1569-9
Popis: The occurrence of a contralateral acute epidural hematoma (AEDH) following removal of an acute subdural hematoma (ASDH) is a rare but nearly devastating postoperative complication. Here, we describe a series of five patients with contralateral AEDH and provide a review of the literature to elucidate the characteristics and improve management of these patients. A total of 386 patients underwent ASDH evacuations in our hospital between August 2008 and July 2011. Five of these patients (1.3 %) developed AEDH that required surgery. Thirty-two additional patients were identified by a search of the PubMed database. Clinical features, surgical treatment, and outcomes (scored by Glasgow outcome scale, GOS) of the collective 37 AEDH cases were analyzed retrospectively. Contralateral AEDH after ASDH evacuation occurred in 27 males (73 %) and 10 females (27 %) (mean age: 35.9 ± 14.2 years). Twenty-six patients (70 %) had unfavorable outcomes (GOS 1–3), and 11 patients (30 %) had favorable outcomes (GOS 4–5). Contralateral skull fractures and intraoperative acute brain swelling occurred in 30 (81 %) and 28 (76 %) patients, respectively. The preoperative Glasgow coma score (GCS) was significantly associated with outcome (p
Databáze: OpenAIRE
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