title: Spontaneous Extradural Hemorrhage in a Patient with Chronic Kidney Disease: A Case Report and Review of Literature.
abstract: BACKGROUND
  Spontaneous extradural hemorrhage is a rare entity. It is usually reported in association with locoregional disease, which is often infective, inflammatory, and hematologic. Chronic kidney disease with hemodialysis is one of the most infrequent causes. The exact association or pathogenesis remains elusive, although possible mechanisms have been suggested. The presentation, associated comorbid conditions, and management vary among the reported cases.
  
  
  METHODS
  A 39-year-old man with hypertension, well controlled with medications, and chronic kidney disease was on maintenance hemodialysis. He later underwent Tenckhoff catheter insertion for peritoneal dialysis; 2 weeks later, when peritoneal dialysis was started, he developed breathlessness. The Tenckhoff catheter was removed. However, the patient developed ascitic leak from the surgical site, which was repaired under general anesthesia. In the immediate postoperative period, he developed sudden, severe headache and was found to have bifrontal extradural hemorrhage. He underwent prompt drainage of the hematoma and was discharged on the fifth postoperative day in stable condition.
  
  
  CONCLUSIONS
  We report a rare case of spontaneous bilateral frontal extradural hemorrhage in the immediate postoperative period in a patient on hemodialysis. In addition, we review the existing literature on the topic.
authors.affiliation: Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Priyank
authors.initials: P
authors.lastname: Yadav
authors.affiliation: Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Alka
authors.initials: A
authors.lastname: Verma
authors.affiliation: Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Arindam
authors.initials: A
authors.lastname: Chatterjee
authors.affiliation: Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Devarshi
authors.initials: D
authors.lastname: Srivastava
authors.affiliation: Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Mohd R
authors.initials: MR
authors.lastname: Riaz
authors.affiliation: Department of Urology and Renal Transplant, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. Electronic address: reverseinnovations@gmail.com.
authors.forename: Ashish
authors.initials: A
authors.lastname: Kannaujia
mesh_terms: D000328:Adult; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy*; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome
keywords: Chronic kidney disease; Hemodialysis; Spontaneous extradural hemorrhage