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慢性硬膜下血肿清除术后出现“蛛网膜下囊肿”:一例罕见术后并发症的病例报告

'Subarachnoid cyst' after evacuation of chronic subdural hematoma: Case report of an unusual postoperative morbidity.

作者信息

Sharon Low Y Y, Wai Hoe N G

机构信息

Department of Neurosurgery, National Neuroscience Institute, Singapore.

出版信息

Asian J Neurosurg. 2016 Jul-Sep;11(3):316. doi: 10.4103/1793-5482.144210.

Abstract

Burr-hole drainage of chronic subdural hematomas are routine operative procedures done by neurosurgical residents. Common postoperative complications include acute epidural and/or subdural bleeding, tension pneumocephalus, intracranial hematomas and ischemic cerebral infarction. We report an interesting post-operative complication of a 'subarachnoid cyst' after burr-hole evacuation of a chronic subdural hematoma. The authors hypothesize that the 'cyst' is likely secondary to the splitting of the adjacent neomembrane within its arachnoid-brain interface by iatrogenic irrigation of the subdural space. Over time, this 'cyst' develops into an area of gliosis which eventually causes long-term scar epilepsy in the patient. As far as we are aware, this is the first complication of such a 'subarachnoid cyst' post burr-hole drainage reported in the literature.

摘要

慢性硬膜下血肿钻孔引流术是神经外科住院医师进行的常规手术操作。常见的术后并发症包括急性硬膜外和/或硬膜下出血、张力性气颅、颅内血肿和缺血性脑梗死。我们报告了1例慢性硬膜下血肿钻孔引流术后出现“蛛网膜囊肿”这一有趣的术后并发症。作者推测,该“囊肿”可能是由于对硬膜下腔进行医源性冲洗,导致相邻新膜在其蛛网膜-脑界面处分离所致。随着时间的推移,这个“囊肿”发展为胶质增生区域,最终导致患者长期瘢痕性癫痫。据我们所知,这是文献中首次报道的钻孔引流术后出现这种“蛛网膜囊肿”的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/794a/4849318/52197fccb13c/AJNS-11-316-g001.jpg

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