title: [Long-term good results of surgical treatment for spontaneous epi- and subdural hematoma in a female patient on maintenance hemodialysis].
abstract: Spontaneous intracranial hematoma is not rare, but with bad prognosis, complication in patients on maintenance hemodialysis (HD). Diagnostic difficulties result from a fact that symptoms of acute hematoma such as headaches,, nausea, vomitis, apathy, sleepiness, parestesia and seizures may also suggest dysequilibrium syndrome, dialytic dementia as well as hypertensive encephalopathy. We describe a case of female patient with 20-year interview data of hypertension on HD since 1981 because of end-stage renal failure in a course of chronic glomerulonephritis, who developed spontaneous epi- and subdural hematoma four year ago in 47 age of life. Performed CT examination confirmed diagnosis and on the same day the patient underwent right frontoparietotemporal craniotomy and the hematoma was removed. During postoperative period, HD sessions were performed without heparin. After surgery the patient developed transcient hypertonia, epileptic sizures and left-sided paresis. Currently, 48 months after craniotomy the patient is fully rehabilitated, with normal blood pressure, without epileptic sizures or palsy. Gradually we discontinued anticonvulsans and antihypertensives.
authors.affiliation: Katedra i Klinika Nefrologii Colegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
authors.forename: W
authors.initials: W
authors.lastname: Sułowicz
authors.forename: A
authors.initials: A
authors.lastname: Kraśniak
authors.forename: I
authors.initials: I
authors.lastname: Gościński
authors.forename: J
authors.initials: J
authors.lastname: Cichoński
authors.forename: M
authors.initials: M
authors.lastname: Moskała
authors.forename: G
authors.initials: G
authors.lastname: Chmiel
authors.forename: E
authors.initials: E
authors.lastname: Janusz-Grzybowska
mesh_terms: D003399:Craniotomy / Q000009:adverse effects; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D020335:Paraparesis / Q000209:etiology / Q000534:rehabilitation; D011859:Radiography; D006435:Renal Dialysis; D012640:Seizures / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome