RESUMO
Contralateral acute complications such as acute epi/subdural hematomas can be encountered after evacuation of a chronic subdural hematoma, though they are rare. We found only one case of chronic subdural hematoma following the surgery for contralateral chronic subdural hematoma, have been published in English language literature. A 73-year-old male admitted to our hospital with a right-sided subdural hematoma. The subdural hematoma was evacuated through a burr-hole. A left-sided subdural higroma appeared after operation and turned into classical subdural hematoma in the course of time. After evacuation of contralateral chronic subdural hematoma, the patient recovered completely. All stages of the development of contralateral chronic subdural hematomas were shown by serial computed tomograms. It was suggested that traumatic chronic subdural hematomas develop from mostly subdural higromas. If contralateral subdural higroma is seen after surgical evacuation of a chronic subdural hematoma, the possibility of development of contralateral chronic subdural hematoma must be kept on mind.
Assuntos
Veias Cerebrais/fisiopatologia , Dura-Máter/fisiopatologia , Hematoma Subdural Crônico/fisiopatologia , Complicações Pós-Operatórias/etiologia , Derrame Subdural/complicações , Espaço Subdural/fisiopatologia , Idoso , Atrofia/etiologia , Atrofia/patologia , Atrofia/fisiopatologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Encéfalo/fisiopatologia , Veias Cerebrais/patologia , Descompressão Cirúrgica/efeitos adversos , Dura-Máter/patologia , Dura-Máter/cirurgia , Lateralidade Funcional/fisiologia , Hematoma Subdural Crônico/etiologia , Hematoma Subdural Crônico/cirurgia , Humanos , Masculino , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/fisiopatologia , Recidiva , Derrame Subdural/fisiopatologia , Espaço Subdural/patologia , Espaço Subdural/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Seventeen patients with depressed fractures over cranial venous sinus who had undergone operations between 1993 and 1998 were reviewed retrospectively. There were 15 male and two female patients. Their ages ranged from 7 to 48 years. The most frequent causes of trauma were motor vehicle accident (in eight cases) followed by assault (in six cases). In the majority of cases, depressed fractures were localized over the superior sagittal sinus, and half of them were over the medial third of the sinus. In 11 cases, massive blood loss occurred intraoperatively that could be controlled by digital pressure with gelfoam or with a free muscle flap. Postoperative infection developed in one case and was treated successfully with antibiotic medication alone. Two patients died due to associated intracerebral lesions. The remaining 15 patients returned to daily living activity in the follow-up period.
