Download PDF
CC BY-NC-ND 4.0 · Indian Journal of Neurotrauma 2021; 18(01): 66-68
DOI: 10.1055/s-0040-1714177
Case Report

Brainstem Bleed after Chronic Subdural Hematoma Drainage

Lamkordor Tyngkan
1   Department of Neurosurgery, Sheri-Kashmir- Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
,
Nayil Malik
1   Department of Neurosurgery, Sheri-Kashmir- Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Chronic subdural hematoma (CSDH) is one of the most frequent benign neurosurgical pathologies. Burr hole drainage is known to be safe, with low-morbidity and low-mortality rates. However, postoperative complications have been reported. We report the case of a 40-year-old lady who suffered a fatal brain stem hemorrhage after burr hole drainage for unilateral chronic SDH. Rapid decompression or sudden increase in cerebral blood flow were the probable factors for her brainstem bleed. Therefore, a slow rate of evacuation of CSDHs and maintenance of a correct blood pressure perioperatively are recommended to prevent serious complications.

Keywords

chronic subdural hematoma - head injury - burr hole evacuation - postoperative complications - brainstem bleed


Publication History

Article published online:
29 September 2020

© 2020. Neurotrauma Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Nayil K, Ramzan A, Sajad A. et al. Subdural hematomas: an analysis of 1181 Kashmiri patients. World Neurosurg 2012; 77 (01) 103-110
    CrossrefPubMedGoogle Scholar
  • 2 Nayil K, Altaf R, Shoaib Y, Wani A, Laharwal M, Zahoor A. Chronic subdural hematomas: single or double burr hole-results of a randomized study. Turk Neurosurg 2014; 24 (02) 246-248
    PubMedGoogle Scholar
  • 3 Kotwica Z, Brzeziński J. Chronic subdural haematoma treated by burr holes and closed system drainage: personal experience in 131 patients. Br J Neurosurg 1991; 5 (05) 461-465
    CrossrefPubMedGoogle Scholar
  • 4 Sambasivan M. An overview of chronic subdural hematoma: experience with 2300 cases. Surg Neurol 1997; 47 (05) 418-422
    CrossrefPubMedGoogle Scholar
  • 5 Weigel R, Schmiedek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 2003; 74 (07) 937-943
    CrossrefPubMedGoogle Scholar
  • 6 McKissock W, Bloom W. Subdural haematoma. A review of 389 cases. Lancet 1960; 1: 1365-1369
    CrossrefPubMedGoogle Scholar
  • 7 Robinson RG. Chronic subdural hematoma: surgical management in 133 patients. J Neurosurg 1984; 61 (02) 263-268
    CrossrefPubMedGoogle Scholar
  • 8 Park K-J, Kang S-H, Lee H-K, Chung Y-G. Brain stem hemorrhage following burr hole drainage for chronic subdural hematoma. Neurol Med Chir (Tokyo) 2009; 49 (05) 94-97
    PubMedGoogle Scholar
  • 9 Alcalá-Cerra G, Gutiérrez-Paternina JJ, Niño-Hernández LM, Polo-Torres C, Romero-Ramírez H, Sabogal-Barrios R. [Intracerebral hemorrhages following drainage of chronic subdural hematomas]. Rev Med Inst Mex Seguro Soc 2011; 49 (05) 547-550
    PubMedGoogle Scholar
  • 10 Rojas-Medina LM, Goel A. Brainstem hemorrhage secondary to evacuation of chronic subdural hematoma. Neurol India 2014; 62 (04) 435-437
    CrossrefPubMedGoogle Scholar
  • 11 Patibandla MR, Thotakura AK, Shukla D, Purohit AK, Addagada GC, Nukavarapu M. Postoperative hematoma involving brainstem, peduncles, cerebellum, deep subcortical white matter, cerebral hemispheres following chronic subdural hematoma evacuation. Asian J Neurosurg 2017; 12 (02) 259-262
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Gader G, Rkhami M, Salem MB, Badri M, Bahri K, Zammel I. A rare complications of chronic subdural hematoma evacuation: brainstem hemorrhage: a case report. Romanian Neurosurgery. 2018; 32: 57
    CrossrefPubMedGoogle Scholar
  • 13 Klintworth GK. The pathogenesis of secondary brainstem hemorrhages as studied in an experimental model. Am J Pathol 1965; 47 (04) 525-536
    PubMedGoogle Scholar
  • 14 Marupaka SK, Sood B. Atypical Duret haemorrhages seen on computed tomography. Emerg Med Australas 2008; 20 (02) 180-182
    CrossrefPubMedGoogle Scholar
  • 15 Kim JK, Kim SW, Kim SH. Intracerebral hemorrhage following evacuation of a chronic subdural hematoma. J Korean Neurosurg Soc 2013; 53 (02) 108-111
    CrossrefPubMedGoogle Scholar
  • 16 Sousa J, Golash A, Vaz J, Chaudhary H. Spontaneous intracerebral haemorrhage following evacuation of chronic subdural hematomas. J Clin Neurosci 2004; 11 (07) 794-796
    CrossrefPubMedGoogle Scholar