He Qiang, Tao Chuan-Yuan, Fu Rui-Hong, You Chao
Department of Neurosurgery, West China Hospital, Chengdu 610041, Sichuan Province, China.
Department of Neurology, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China.
World J Clin Cases. 2022 Feb 26;10(6):1863-1868. doi: 10.12998/wjcc.v10.i6.1863.
Epidural hematoma is one of the common postoperative complications after craniotomy. However, multiple remote epidural hematomas in different sites, including supratentorial and infratentorial regions, are exceedingly rare.
We present a rare case in which three remote epidural hematomas occurred after craniotomy. A 21-year-old woman was admitted with a headache for 1 mo, vomiting, and rapid vision loss for 1 wk. Brian magnetic resonance imaging indicated a right thalamic tumor. The intraoperative diagnosis was a cystic tumor, posterior cerebral artery aneurysm, and vascular malformation. The operation was successful. Unfortunately, the patient developed three extradural hematomas within 48 h. Family members consented to the first two hematoma evacuations but refused the third.
More attention should be paid to this kind of rare complication. Adequate preoperative evaluation is important, especially for acute patients. Monitoring neural function and early computed tomography scanning of the brain after surgery should be highlighted.
硬膜外血肿是开颅术后常见的并发症之一。然而,在不同部位(包括幕上和幕下区域)出现多个远处硬膜外血肿极为罕见。
我们报告一例罕见病例,患者开颅术后出现三处远处硬膜外血肿。一名21岁女性因头痛1个月、呕吐及视力迅速下降1周入院。脑部磁共振成像显示右侧丘脑肿瘤。术中诊断为囊性肿瘤、大脑后动脉瘤及血管畸形。手术成功。不幸的是,患者在48小时内出现三处硬膜外血肿。家属同意对前两处血肿进行清除,但拒绝了第三次。
应更加关注这类罕见并发症。充分的术前评估很重要,尤其是对于急症患者。术后应重视神经功能监测及早期脑部计算机断层扫描。