Intracerebral hemorrhage immediately following surgical treatment of chronic subdural hematoma. Report of two cases.

Abstract

Two rare cases of intracerebral hematoma which were encountered immediately after the surgical treatment of an intracranial chronic subdural hematoma were reported. In Case 1, a 70-year-old man deteriorated immediately following the irrigation of a chronic subdural hematoma. The carotid angiogram obtained two hours after the operation revealed a subcortical hemorrhage beneath the previously operated area, and this intracerebral hematoma was verified by the second operation four hours after the first. In Case 2, a 78-year-old woman immediately developed complete left hemiplegia and a drowsy state after removal of chronic subdural hematoma by craniotomy. About twenty hours after the operation, a follow-up CT scan revealed an intracerebral hematoma just beneath the previously removed hematoma in the right temporo-parietal lobe. Based on these experiences, although rare, the development of an intracerebral hemorrhage must be considered if a patient deteriorates immediately following surgical treatment of a chronic subdural hematoma. The possible reasons for the appearance of such intracerebral hematomas were also discussed.