Epidural and subdural haematomas as a complication of internal drainage of cerebrospinal fluid in hydrocephalus.

Abstract

After mentioning the most important indications for the implantation of atrio-ventricular systems in increased intracranial pressure, the importance of epidural and/or subdural bleeding as one of the main postoperative complications is pointed out. In the literature, known to us, there are reports of 9 epidural and 25 subdural haematomas. Four more personal cases are reported. The cause of the bleeding is collapse of the cortex which leads to rupture of cortical veins or epidural vessels. Especially at risk are adult patients with high intracranial pressure or atrophy of the cortex in long standing hydrocephalus. Epidural haematoma always develops in the first few hours after the operation, whereas subdural haematomas may develop either in the first days or even after weeks and months. The incidence of this complication in our adult patients is 5.6%. Some possibilities for the prophylaxis of intracranial bleeding are mentioned.