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后颅窝手术后幕上脑实质内远处出血:一种罕见情况。

Remote supratentorial intraparenchymal bleed after posterior fossa surgery: A rare occurrence.

作者信息

Moaiyadi Abbas Hibtullah, Tripathi Mayank, Lanjewar Pavan Tulshiram, Syal Simran Kaur, Singh Binoy Kumar, Anjankar Shailendra, Gandhoke Charandeep Singh

机构信息

Department of Neurosurgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

出版信息

Surg Neurol Int. 2024 Mar 15;15:83. doi: 10.25259/SNI_748_2023. eCollection 2024.

Abstract

BACKGROUND

Intraparenchymal hemorrhage at the operative site is one of the major complications of brain surgery. It is unusual to occur at a site remote from the operative site, but when it happens, it may cause significant morbidity and mortality.

CASE DESCRIPTION

We report the case of a 27-year-old male who presented with complaints of paresthesias over the left side of his face and decreased hearing from the left ear for two years. His radiology was suggestive of a large left cerebellopontine angle epidermoid cyst. The patient underwent left retro mastoid suboccipital craniotomy and near-total excision of the epidermoid cyst. The immediate postoperative non-contrast computed tomography scan of the brain was suggestive of no hematoma at the operated site but a remote left parafalcine frontoparietal intraparenchymal bleed, which was managed conservatively. At two months follow-up, he had no neuro deficits, and magnetic resonance imaging of the brain was suggestive of near-total excision of the epidermoid cyst with resolving left parafalcine frontoparietal bleed.

CONCLUSION

We report this case due to the unique case observation of an intracranial bleed at a remote site rather than at the operated site.

摘要

背景

手术部位的脑实质内出血是脑外科手术的主要并发症之一。在远离手术部位的地方发生这种情况并不常见,但一旦发生,可能会导致严重的发病率和死亡率。

病例描述

我们报告一例27岁男性患者,他诉说左侧面部感觉异常及左耳听力下降已有两年。影像学检查提示左侧桥小脑角有一个巨大的表皮样囊肿。患者接受了左侧枕下乙状窦后开颅手术,几乎完全切除了表皮样囊肿。术后即刻脑部非增强计算机断层扫描显示手术部位无血肿,但左侧大脑镰旁额顶叶脑实质内有一处远处出血,对此进行了保守治疗。在两个月的随访中,他没有神经功能缺损,脑部磁共振成像提示表皮样囊肿几乎完全切除,左侧大脑镰旁额顶叶出血正在吸收。

结论

我们报告此病例是因为观察到了一个独特的情况,即颅内出血发生在远离手术部位的地方,而非手术部位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae51/11021087/948f6459b050/SNI-15-83-g001.jpg

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