Intracerebral Hematoma Following Evacuation of Chronic Subdural Hematoma: A Case Report and Review of Literature

Abstract

Intracerebral hematoma is an unusual complication following surgical evacuation of chronic subdural hematoma. We report a case of 61-year-old patient operated at our department for a right-sided chronic subdural hematoma (CSDH), who presented with mild headache and left hemiparesis (4/5, Medical Research Council [MRC] grade). Postoperatively, the patient developed a small hematoma in ipsilateral frontal lobe. Serial computed tomography (CT) of the head showed progressive increase in size of hematoma with development of motor dysphasia. Frontal hematoma was evacuated by craniotomy and the patient improved in motor dysphasia. We emphasize the rarity of this complication and discuss the pathogenesis as well as management of this condition.

Keywords

chronic subdural hematoma - intracerebral hematoma - surgery - good outcome

• References

• 1 McKissock W, Richardson A, Bloom WH. Subdural hematoma: a review of 389 cases. Lancet 1960; 1: 1365-1369
• 2 Ogasawara K, Koshu K, Yoshimoto T, Ogawa A. Transient hyperemia immediately after rapid decompression of chronic subdural hematoma. Neurosurgery 1999; 45 (03) 484-488 discussion 488–489
• 3 Rohde V, Graf G, Hassler W. Complications of burr-hole craniostomy and closed-system drainage for chronic subdural hematomas: a retrospective analysis of 376 patients. Neurosurg Rev 2002; 25 (01) (02) 89-94
• 4 d'Avella D, De Blasi F, Rotilio A, Pensabene V, Pandolfo N. Intracerebral hematoma following evacuation of chronic subdural hematomas. Report of two cases. J Neurosurg 1986; 65 (05) 710-712
• 5 Sato M, Nakano M, Asari J, Watanabe K. Intracerebral haemorrhage during surgery for chronic subdural haematoma. J Clin Neurosci 2007; 14 (01) 81-83
• 6 Missori P, Salvati M, Polli FM, Conserva V, Delfini R. Intraparenchymal haemorrhage after evacuation of chronic subdural haematoma. Report of three cases and review of the literature Br J Neurosurg 2002; 16 (01) 63-66
• 7 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
• 8 Choi KY, Lee JK, Jang JW, Seo BR, Kim TS, Kim JH. Spontaneous Intracerebral Hemorrhage Occurring during Progression of Chronic Subdural Hematoma. J Kor Neurotraumatol Soc 2011; 7 (01) 43-46
• 9 Akhaddar A, Ajja A, Elmostarchid B, Boucetta M. Combined epidural and intracerebral hematomas after evacuation of bilateral chronic subdural hematoma. Neurochirurgie 2008; 54 (06) 728-730
• 10 Hirakawa T, Tanaka A, Yoshinaga S, Ohkawa M, Tomonaga M. Calcified chronic subdural hematoma with intracerebral rupture forming a subcortical hematoma. A case report. Surg Neurol 1989; 32 (01) 51-55
• 11 Marmarou A, Shulman K, Rosende RM. A nonlinear analysis of the cerebrospinal fluid system and intracranial pressure dynamics. J Neurosurg 1978; 48 (03) 332-344