title: Sudden worsening after subdural haematoma surgery: will there be a corpus callosum injury?
abstract: We report a case of mild encephalopathy with a reversible splenial lesion (MERS) which occurred after chronic subdural haematoma (CSDH) surgery. The patient was admitted to our hospital for drowsiness and marked asthenia. The cerebral CT scan revealed a CSDH and surgery allowed to improve the symptoms, but after several days we observed a sudden worsening. The patient developed left-sided myoclonic seizures followed by left hemiplegia and worsening drowsiness. Electrolytes imbalance and inflammatory causes were excluded. The CT scan showed a right cerebral swelling and the subsequent MRI revealed a single lesion in the splenium of the corpus callosum, hyperintense on diffusion-weighted images. After osmotic therapy the patient improved and on day 10 of admission the MRI showed a complete resolution of the lesion. This is the first report that described an association between CSDH and MERS. Possible aetiopathogenetic mechanisms are discussed.
authors.affiliation: Department of Neuroscience, Division of Neurosurgery, University of Brescia, Brescia, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Panciani
authors.affiliation: Department of Neuroscience, Division of Neurosurgery, University of Brescia, Brescia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Roca
authors.affiliation: Department of Neuroscience, Division of Diagnostic Imaging, University of Brescia, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lodoli
authors.affiliation: Department of Neuroscience, Division of Neurosurgery, University of Brescia, Brescia, Italy.
authors.forename: Marco Maria
authors.initials: MM
authors.lastname: Fontanella
mesh_terms: D001929:Brain Edema / Q000175:diagnosis* / Q000209:etiology; D003337:Corpus Callosum / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D020200:Hematoma, Subdural, Chronic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed