title: [Spontaneous epidural hematoma after open heart surgery: case report].
abstract: Acute epidural hematoma not associated with head injury is rarely encountered and is known as spontaneous epidural hematoma. To our knowledge, only five cases with epidural hematoma after open-heart surgery have been published. Pathogenesis and preventive measures have not yet been determined. We report a case of such spontaneous epidural hematoma and consider the possible pathogenesis. A 12-year-old female received a radical operation for severe subaortic stenosis. The intraoperative course was uneventful except for massive hemorrhage which was adequately controlled. Postoperatively, she was moved to the CCU still not having aroused from anesthesia. Eleven hours later, it was found that her pupils were fixed and dilated. CT scan demonstrated a huge bifrontal epidural hematoma with disappearance of the basal cistern. Even though immediate emergency evacuation was performed, the patient died of acute brain swelling four days after the operation.
authors.affiliation: Department of Neurosurgery, Institute of Neurosciences, St. Mary's Hospital, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Anegawa
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Furukawa
authors.forename: T
authors.initials: T
authors.lastname: Nagashima
authors.forename: M
authors.initials: M
authors.lastname: Kumate
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002648:Child; D017809:Fatal Outcome; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007427:Intracranial Pressure; D011183:Postoperative Complications
chemical_list: D000925:Anticoagulants