Contralateral subdural effusion related to decompressive craniectomy performed in patients with severe traumatic brain injury.
BACKGROUND
Contralateral subdural effusion caused by decompressive craniectomy (DC) is not uncommon. However, it has rarely been reported.


METHODS
From 2004 to 2008, 123 severe traumatic brain injury (TBI) patients were identified as having undergone DC for increased intracranial pressure (IICP) with or without removal of a blood clot or contused brain. Of these 123 patients, nine developed delayed contralateral subdural effusion. Demographics, clinical presentations, treatment and outcome were reported.


RESULTS
The overall incidence of contralateral subdural effusion was 7.3%. On average, this complication was found 23 days after DC. Of the nine patients, six had neurological deterioration and received drainage through a burr hole. One patient needed a subsequent subduro-peritoneal shunting because of recurrent subdural effusion.


CONCLUSIONS
Contralateral subdural effusions may be not uncommon and need more aggressive treatment because of their tendency to cause midline shift. Surgical intervention may be warranted if the patients develop deteriorating clinical manifestations or if the subdural effusion has an apparent mass effect.
Wang
Hao-Kuang
HK
Department of Neurosurgery, E-Da Hospital, I-Shou University, I-Shou University, 1 Yi-Da Road, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan.
Lu
Kang
K
Liang
Cheng-Loong
CL
Tsai
Yu-Duan
YD
Wang
Kuo-Wei
KW
Liliang
Po-Chou
PC
D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000601:surgery*; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013353:Subdural Effusion / Q000209:etiology*; D016896:Treatment Outcome