Shen Jian, Fan Zuoxu, Ji Tao, Pan Jianwei, Zhou Yongqing, Zhan Renya
Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 Zhejiang Province, PRC.
Neurol Med Chir (Tokyo). 2013;53(4):221-4. doi: 10.2176/nmc.53.221.
Contralateral acute subdural hematoma (ASDH) occurring after removal of traumatic ASDH is a rare, but nearly devastating postoperative complication. We treated a 26-year-old male who developed a contralateral ASDH shortly after craniectomy for evacuation of a traumatic ASDH. Burr-hole craniotomy was performed before decompressive craniectomy, and the bleeding source was a cortex artery within the frontal lobe contusion. Despite supportive therapy with barbiturate and mild hypothermia he expired 3 days later of brain death. Literature review suggests that the old are more susceptible to contralateral ASDH following evacuation of traumatic ASDH. Contralateral ASDH following evacuation of traumatic ASDH is a rare but potentially lethal complication, so neurosurgeons should try to detect such contralateral hematoma formation and prevent clinical deterioration.
创伤性急性硬膜下血肿（ASDH）清除术后发生对侧急性硬膜下血肿是一种罕见但几乎具有毁灭性的术后并发症。我们治疗了一名26岁男性，他在因创伤性ASDH行颅骨切除术以清除血肿后不久出现了对侧ASDH。在减压性颅骨切除术之前进行了钻孔开颅术，出血源是额叶挫伤内的皮质动脉。尽管采用巴比妥酸盐和轻度低温进行支持治疗，但他在3天后因脑死亡而死亡。文献综述表明，老年人在创伤性ASDH清除术后更容易发生对侧ASDH。创伤性ASDH清除术后的对侧ASDH是一种罕见但可能致命的并发症，因此神经外科医生应努力检测这种对侧血肿形成并防止临床病情恶化。
