title: Intraoperative Supratentorial Extradural Hematoma Complicating Excision of a Giant Vestibular Schwannoma.
abstract: BACKGROUND
  A man developed a rare and unexpected contralateral intraoperative complication during a translabyrinthine resection of a large cystic vestibular schwannoma.
  
  
  METHODS
  A 29-year-old man presented with progressive, low-level right-sided tinnitus and hearing loss. Magnetic resonance imaging displayed a large multicystic lesion suggestive of a vestibular schwannoma extending into the right cerebellopontine angle and distorting the midbrain. The patient subsequently underwent translabyrinthine excision of the lesion. The operation was complicated by brain swelling that obscured the operative field. Cerebrospinal fluid drainage failed to improve operative conditions, and an urgent computed tomography scan was performed, which showed a large supratentorial extradural hematoma as the cause. This extradural collection was promptly evacuated, and the patient had a good neurologic recovery postoperatively.
  
  
  CONCLUSIONS
  Although the development of postoperative extradural hematomas resulting from cerebrospinal fluid overdrainage is reported in the literature, this case is unique in that infratentorial surgery led to the development of a supratentorial hematoma.
authors.affiliation: Department of Neurosurgery, Salford Royal Hospital, Salford, Greater Manchester, United Kingdom. Electronic address: Daniel.lewis@srft.nhs.uk.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Lewis
authors.affiliation: Department of Otolaryngology, Manchester Royal Infirmary, Manchester, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Lloyd
authors.affiliation: Department of Neurosurgery, Salford Royal Hospital, Salford, Greater Manchester, United Kingdom.
authors.forename: Omar N
authors.initials: ON
authors.lastname: Pathmanaban
authors.affiliation: Department of Neurosurgery, Salford Royal Hospital, Salford, Greater Manchester, United Kingdom.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hammerbeck-Ward
authors.affiliation: Department of Neurosurgery, Salford Royal Hospital, Salford, Greater Manchester, United Kingdom.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Rutherford
authors.affiliation: Department of Neurosurgery, Salford Royal Hospital, Salford, Greater Manchester, United Kingdom.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: King
mesh_terms: D000328:Adult; D002530:Cerebellopontine Angle / Q000000981:diagnostic imaging / Q000473:pathology; D006407:Hematoma, Epidural, Cranial / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000000981:diagnostic imaging / Q000473:pathology; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000601:surgery*; D009464:Neuroma, Acoustic / Q000000981:diagnostic imaging / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D015898:Tomography Scanners, X-Ray Computed
keywords: Complication; Extradural hematoma; Skull base; Supratentorial hematoma; Translabyrinthine; Vestibular schwannoma