title: Bilateral acute epidural hematoma after evacuation of acute subdural hematoma: brain shift and the dynamics of extraaxial collections.
abstract: Acute epidural hematoma following supratentorial decompressive craniectomy is a very seldom described but serious complication. The occurrence of intraoperative brain swelling may suggest the development of a contralateral hematoma. A unique case of bilateral acute epidural following decompressive craniectomy and evacuation of acute subdural hematoma is presented. Awareness of unexplained elevation of intracranial pressure is of paramount importance when routine immediate postoperative computed tomography is not performed. This case provides insight into the well-known but poorly understood dynamic process of brain shift and extraaxial collections.
authors.affiliation: Department of Neurosurgery, Endovascular Neurosurgery and Interventional Neuroradiology, Hadassah University Hospital, Jerusalem, Israel. jcohenns@yahoo.com
authors.forename: José E
authors.initials: JE
authors.lastname: Cohen
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rajz
authors.forename: Eyal
authors.initials: E
authors.lastname: Itshayek
authors.forename: Felix
authors.initials: F
authors.lastname: Umansky
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects*; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology*; D020199:Hematoma, Subdural, Acute / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D017063:Outcome Assessment, Health Care; D014057:Tomography, X-Ray Computed