Abstract:
Chronic subdural hematoma (CSDH) and symptomatic subdural hygroma are common diseases that require neurosurgical management. Burr hole trephination is the most popular surgical treatment for CSDH and subdural hygroma because of a low recurrence rate and low morbidity compared with craniotomy with membranectomy, and twist-drill craniotomy. Many reports suggest that placing a catheter in the subdural space for drainage can further reduce the rate of recurrence; however, complications associated with this type of drainage include acute subdural hematoma, cortical injury, and infection. Remote hemorrhage due to overdrainage of cerebrospinal fluid (CSF) is another possible complication of burr hole trephination with catheter drainage that has rarely been reported. Here, we present 2 cases of remote hemorrhages following burr hole trephination with catheter drainage for the treatment of CSDH and symptomatic subdural hygroma. One patient developed intracerebral hemorrhage and subarachnoid hemorrhage in the contralateral hemisphere, while another patient developed remote hemorrhage 3 days after the procedure due to the sudden drainage of a large amount of subdural fluid over a 24-hour period. These findings suggest that catheter drainage should be carefully monitored to avoid overdrainage of CSF after burr hole trephination.
摘要:
慢性硬膜下血肿(CSDH)和有症状的硬膜下积液是需要神经外科治疗的常见疾病。毛孔钻孔术是CSDH和硬膜下积液最受欢迎的手术治疗方法,因为与开颅术和膜切除术相比,复发率低,发病率低。和麻花钻开颅术.许多报告表明,在硬膜下间隙放置导管进行引流可以进一步降低复发率;然而,与这种类型的引流相关的并发症包括急性硬膜下血肿,皮质损伤,和感染。由于脑脊液(CSF)的过度引流导致的远程出血是导管引流的毛刺孔钻孔的另一种可能的并发症,很少有报道。这里,我们介绍了2例钻孔钻孔导管引流术治疗CSDH和有症状的硬膜下积液后的远端出血。一名患者在对侧半球出现脑出血和蛛网膜下腔出血,而另一名患者在手术后3天由于24小时内突然引流大量硬膜下液体而出现远程出血。这些发现表明,应仔细监测导管引流,以避免毛刺孔钻孔后脑脊液过度引流。