Acute Epidural Hematoma after Evacuation of Chronic Subdural Hematoma
Journal Title: Nepal Journal of Neuroscience - Year 2009, Vol 6, Issue 2
Abstract
Epidural hematoma following chronic subdural hematoma (CSDH) is a rare complication. CSDH is a liquefied blood on the surface of the brain beneath its outer covering occurring most commonly in elderly. They occur in an average age of 56 to 63 years old with an incidence of 1.72 cases per 1.000.000. The possible cause is atrophy of the brain and minor trauma resulting in slow collection of blood. Treatment consists of surgical evacuation by single or two burr hole, twist drill craniostomy with or without a drain. The complications following evacuation include acute epidural hematoma (EDH) at the same or opposite site, intraparenchymal hematoma, cerebellar hematoma, acute subdural hematoma and infection. We report a case of CSDH evacuation in a young male following which the patient did not improve and repeat scan showed a massive acute epidural hematoma. The patient underwent emergency craniotomy and evacuation of the EDH following which he improved. Although uncommon, this complication must be kept in mind in those cases who do not improve clinically after CSDH evacuation or who have signs of deterioration. A urgent computerized tomography (CT) scan and surgical evacuation can help save life and prevent further morbidity.
Authors and Affiliations
Yam B Roka, MS, MCh
Keywords
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