Brain stem hemorrhage following burr hole drainage for chronic subdural hematoma-case report-.
A 76-year-old man presented with brain stem hemorrhage after burr-hole drainage for bilateral chronic subdural hematomas. Neuroimaging demonstrated resolution of the transtentorial herniation but also detected new brain stem hemorrhage, manifesting as gait disturbance. He recovered after conservative treatment. Asymmetrical and rapid decompression, which leads to vascular disruption and/or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem hemorrhage. Therefore, simultaneous and bilateral decompression with a slow rate of evacuation of massive bilateral chronic subdural hematomas is recommended to prevent serious complications such as secondary intracranial hematoma.
Park
Kyung-Jae
KJ
Department of Neurosurgery, Korea University, College of Medicine, Seongbuk-Gu, Seoul, Korea.
Kang
Shin-Hyuk
SH
Lee
Hoon-Kap
HK
Chung
Yong-Gu
YG
D000368:Aged; D001488:Basilar Artery / Q000293:injuries / Q000503:physiopathology; D001933:Brain Stem / Q000098:blood supply / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D020233:Gait Disorders, Neurologic / Q000209:etiology; D020200:Hematoma, Subdural, Chronic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006547:Hernia / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D020300:Intracranial Hemorrhages / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D019586:Intracranial Hypertension / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D020127:Recovery of Function / Q000502:physiology; D013396:Suction / Q000009:adverse effects* / Q000379:methods; D014057:Tomography, X-Ray Computed