Abstract
BackgroundDelayed epidural hematoma (DEH) following evacuation of traumatic acute subdural hematoma (ASDH) or acute epidural hematoma (EDH) is a rare but devastating complication, especially when it occurs sequentially in a single patient.Case presentationA 19-year-old man who developed contralateral DEH following craniotomy for evacuation of a traumatic right-side ASDH and then developed a left-side DEH of the posterior cranial fossa after craniotomy for evacuation of the contralateral DEH. He was immediately returned to the operating room for additional surgeries and his neurological outcome was satisfactory.ConclusionsAlthough DEH occurring after evacuation of ASDH or acute EDH is a rare event, timely recognition is critical to prognosis.
Highlights
Delayed epidural hematoma (DEH) following evacuation of traumatic acute subdural hematoma (ASDH) or acute epidural hematoma (EDH) is a rare but devastating complication, especially when it occurs sequentially in a single patient.Case presentation: A 19-year-old man who developed contralateral DEH following craniotomy for evacuation of a traumatic right-side ASDH and developed a left-side DEH of the posterior cranial fossa after craniotomy for evacuation of the contralateral DEH
We report a case involving a Chinese man who developed contralateral DEH following decompressive surgery for right-side ASDH, and developed an additional remote DEH following decompressive surgery for the contralateral DEH
With no clotting dysfunction according laboratory tests. He was subsequently transferred to the operating room and underwent a right decompressive craniectomy
Summary
Delayed epidural hematoma (DEH) is an uncommon complication following evacuation of intracranial hematomas, it is devastating especially following the evacuation of traumatic acute subdural hematoma (ASDH). With no clotting dysfunction according laboratory tests He was subsequently transferred to the operating room and underwent a right decompressive craniectomy. Owing to a mass effect from the DEH and severe brain swelling, the patient was immediately taken to the operating room to undergo a left hematoma evacuation and decompressive craniectomy. An immediate brain CT scan revealed evidence of left-side DEH of the posterior cranial fossa (Fig. 4). Owing to mass effect of the DEH, a third surgery was offered He underwent left posterior cranial fossa hematoma evacuation and decompressive craniectomy. The patient recovered to a GCS of 7 within days after surgery, and was transferred to the rehabilitation hospital He was discharged from the rehabilitation hospital with a Glasgow Outcome Score of 4. He underwent cranioplasty 1 year later and has since recovered well
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