PDF(Pubmed)
Abstract：
UNASSIGNED: Contralateral subdural effusion (CSDE) is a rare complication secondary to decompressive craniectomy (DC), which can lead to encephalocele and neurologic deterioration. The authors report a case that confirm the existence of unidirectional membrane valve, and cranioplasty is an effective treatment for CSDE.
UNASSIGNED: The authors reported a case of 43-year-old female was diagnosed with ruptured intracranial aneurysm and treated with interventional embolization. She underwent DC because of postoperative cerebral infarction subsequently. Her conscious state deteriorated accompanied by encephalocele in postoperative 2 week. A craniocerebral computed tomography (CT) confirmed the diagnosis of CSDE with cerebral hernia. A compression bandaging of the skull defect was applicated, whereas, her conscious state progressive deteriorated. She was transferred to the author\'s hospital where she underwent burr-hole drainage and clinical symptom has been improved. However, a relapse of CSDE was observed after the removal of drainage tube. Continuous lumbar drainage was employed, and which was ineffective for CSDE in this case. Finally, she underwent cranioplasty, with the help of drainage of subdural effusion, CSDE was completely resolved.
UNASSIGNED: CSDE is occasionally observed in patients after DC. Intracranial pressure (ICP) gradient and unidirectional membrane valve are the possible mechanisms of CSDE. At present, there is no optimal therapy for CSDE. For symptomatic CSDE patients, one or more treatment measures should be applicated.
UNASSIGNED: Cranioplasty is one of the curative and optimal method to treat symptomatic CSDE patients, early cranioplasty combined with burr-hole drainage should be performed for conservative treatment failed and intractable cases.
UNASSIGNED: The authors reported a case of 43-year-old female was diagnosed with ruptured intracranial aneurysm and treated with interventional embolization. She underwent DC because of postoperative cerebral infarction subsequently. Her conscious state deteriorated accompanied by encephalocele in postoperative 2 week. A craniocerebral computed tomography (CT) confirmed the diagnosis of CSDE with cerebral hernia. A compression bandaging of the skull defect was applicated, whereas, her conscious state progressive deteriorated. She was transferred to the author\'s hospital where she underwent burr-hole drainage and clinical symptom has been improved. However, a relapse of CSDE was observed after the removal of drainage tube. Continuous lumbar drainage was employed, and which was ineffective for CSDE in this case. Finally, she underwent cranioplasty, with the help of drainage of subdural effusion, CSDE was completely resolved.
UNASSIGNED: CSDE is occasionally observed in patients after DC. Intracranial pressure (ICP) gradient and unidirectional membrane valve are the possible mechanisms of CSDE. At present, there is no optimal therapy for CSDE. For symptomatic CSDE patients, one or more treatment measures should be applicated.
UNASSIGNED: Cranioplasty is one of the curative and optimal method to treat symptomatic CSDE patients, early cranioplasty combined with burr-hole drainage should be performed for conservative treatment failed and intractable cases.
摘要：
■对侧硬膜下积液（CSDE）是去骨瓣减压术（DC）继发的罕见并发症，会导致脑膨出和神经系统恶化.作者报告了一个证实存在单向膜阀的案例，颅骨修补术是CSDE的有效治疗方法。
■作者报道了一例43岁女性患者被诊断为颅内动脉瘤破裂，并接受介入栓塞治疗。她随后因术后脑梗死而接受了DC。术后2周意识状态恶化，伴有脑膨出。颅脑计算机断层扫描（CT）证实了CSDE合并脑疝的诊断。应用颅骨缺损的加压包扎，然而,她的意识状态逐渐恶化。她被转移到提交人的医院，在那里她接受了钻孔引流，临床症状得到了改善。然而,拔除引流管后观察到CSDE复发.采用持续腰大池引流，在这种情况下对CSDE无效。最后,她做了颅骨修补术,在硬膜下积液引流的帮助下，CSDE已完全解决。
■在DC后的患者中偶尔观察到CSDE。颅内压（ICP）梯度和单向膜阀是CSDE的可能机制。目前,CSDE没有最佳治疗方法。对于有症状的CSDE患者，应采取一种或多种治疗措施。
■颅骨成形术是治疗有症状的CSDE患者的最佳治疗方法之一，对于保守治疗失败和棘手的病例，应进行早期颅骨修补术和钻孔引流。
■作者报道了一例43岁女性患者被诊断为颅内动脉瘤破裂，并接受介入栓塞治疗。她随后因术后脑梗死而接受了DC。术后2周意识状态恶化，伴有脑膨出。颅脑计算机断层扫描（CT）证实了CSDE合并脑疝的诊断。应用颅骨缺损的加压包扎，然而,她的意识状态逐渐恶化。她被转移到提交人的医院，在那里她接受了钻孔引流，临床症状得到了改善。然而,拔除引流管后观察到CSDE复发.采用持续腰大池引流，在这种情况下对CSDE无效。最后,她做了颅骨修补术,在硬膜下积液引流的帮助下，CSDE已完全解决。
■在DC后的患者中偶尔观察到CSDE。颅内压（ICP）梯度和单向膜阀是CSDE的可能机制。目前,CSDE没有最佳治疗方法。对于有症状的CSDE患者，应采取一种或多种治疗措施。
■颅骨成形术是治疗有症状的CSDE患者的最佳治疗方法之一，对于保守治疗失败和棘手的病例，应进行早期颅骨修补术和钻孔引流。
