Sato M, Mori K
No Shinkei Geka. 1981 Oct;9(11):1297-302.
Postoperative epidural hematomas developed far from the operative field are generally recognized as a complication of ventriculo-peritoneal shunt, ventricular drainage or suboccipital craniotomy. It is very rare but may occur after supratentorial craniotomy on the contralateral side. Five such cases are presented with a review of the relevant literature. The mechanism of this complication is not clearly understood. In hydrocephalus, these massive epidural hematomas are probably caused by dura-skull detachment when the brain volume is strikingly reduced by a decompressive procedure. On rare occasions, pins of head rest may detach the dura and cause epidural hematomas. When sudden brain swelling during craniotomy is encountered, attention should be directed not only to intracerebral hemorrhage but also epidural hematoma developed on the contralateral side.
远离手术区域发生的术后硬膜外血肿通常被认为是脑室-腹腔分流术、脑室引流术或枕下开颅术的并发症。这种情况非常罕见,但也可能发生在对侧幕上开颅术后。本文报告了5例此类病例,并对相关文献进行了综述。这种并发症的机制尚不清楚。在脑积水患者中,这些巨大的硬膜外血肿可能是由于减压手术使脑体积显著减小,导致硬脑膜与颅骨分离所致。在极少数情况下,头架的固定针可能会使硬脑膜分离并导致硬膜外血肿。当开颅术中遇到突然的脑肿胀时,不仅要注意脑内出血,还要注意对侧发生的硬膜外血肿。