急性硬膜下血肿手术清除术后对侧硬膜下血肿：超早期干预及临床意义
Contralateral Subdural Hematoma Following Surgical Evacuation of Acute Subdural Hematoma: Super-Early Intervention and Clinical Implications.
作者信息
Lv Junhui, Qi Xuchen, Wang Yirong, Wu Haijian, Wang Kun, Niu Huanjiang, Li Xinwei
机构信息
Department of Neurosurgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Department of Neurosurgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
出版信息
World Neurosurg. 2019 Feb;122:24-27. doi: 10.1016/j.wneu.2018.10.106. Epub 2018 Oct 25.
BACKGROUND
Contralateral acute subdural hematoma (ASDH) is an uncommon but devastating complication during craniotomy and hematoma evacuation. It can lead to extremely poor outcomes if not treated properly and promptly.
CASE DESCRIPTION
We present a case of a 49-year-old male who suffered contralateral ASDH during surgical evacuation of ASDH on the left side. Before the operation, we noticed slight contralateral ASDH on preoperative cranial computed tomography and were aware of its enlargement during operation. Decompression with a burr-hole craniotomy promptly followed by a decompressive craniectomy was performed to prevent contralateral ASDH. Unfortunately, we found intraoperative brain swelling, which indicated the development of a contralateral hematoma. The patient was reoperated and eventually had a poor prognosis.
CONCLUSIONS
We highlight that super-early intervention of contralateral hematoma is important to improve the prognosis of these patients.
背景
对侧急性硬膜下血肿（ASDH）是开颅手术和血肿清除过程中一种罕见但具有毁灭性的并发症。如果处理不当或不及时，可能导致极其糟糕的预后。
病例描述
我们报告一例49岁男性患者，在左侧急性硬膜下血肿手术清除过程中发生对侧急性硬膜下血肿。术前头颅计算机断层扫描显示对侧有轻微急性硬膜下血肿，术中发现其增大。为预防对侧急性硬膜下血肿，立即进行钻孔开颅减压，随后行去骨瓣减压术。不幸的是，术中发现脑肿胀，提示对侧血肿形成。患者接受再次手术，最终预后不良。
结论
我们强调，对侧血肿的超早期干预对于改善这些患者的预后至关重要。
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