Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents
Aykut Akpinar, Necati Ucler, Uzay Erdogan, Cem Seyho Yucetas
(Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkey)
Am J Case Rep 2015; 16:430-433
Chronic subdural hematoma generally occurs in the elderly. After chronic subdural hematoma evacuation surgery, the development of epidural hematoma is a very rare entity.
CASE REPORT: We report the case of a 41-year-old man with an epidural hematoma complication after chronic subdural hematoma evacuation. Under general anesthesia, the patient underwent a large craniotomy with closed system drainage performed to treat the chronic subdural hematoma. After chronic subdural hematoma evacuation, there was epidural leakage on the following day.
CONCLUSIONS: Although trauma is the most common risk factor in young CSDH patients, some other predisposing factors may exist. Intracranial hypotension can cause EDH. Craniotomy and drainage surgery can usually resolve the problem. Because of rapid dynamic intracranial changes, epidural leakages can occur. A large craniotomy flap and silicone drainage in the operation area are key safety points for neurosurgeons and hydration is essential.
Keywords: Craniotomy - methods, Chronic Disease, Adult, Drainage - adverse effects, Hematoma, Epidural, Cranial - surgery, Hematoma, Subdural, Chronic - surgery, Humans, Male, Postoperative Complications, Tomography, X-Ray Computed