Transient hyperemia immediately after rapid decompression of chronic subdural hematoma.

Abstract:

OBJECTIVE:Intracerebral hemorrhage occurring after removal of a chronic subdural hematoma (CSH) is a rare but usually devastating postoperative complication. In patients with CSH, we determined cerebral blood flow immediately after surgical decompression to clarify the pathogenic mechanism of this complication. METHODS:In 22 patients with unilateral CSH, a catheter was inserted into the hematoma cavity through a single burr hole without leakage of the contents. Cerebral blood flow was measured using single-photon emission computed tomography 1 day before surgery, immediately after rapid decompression by opening the catheter, and 3 days after surgery. RESULTS:Single-photon emission computed tomography imaging immediately after decompression demonstrated areas of hyperemia in nine patients (41%). In all nine patients, hyperemia was observed in the cortex beneath the CSH, and it disappeared on the 3rd postoperative day. The patients with hyperemia were significantly older than those without hyperemia. Other variables, including preoperative cerebral blood flow, intrahematoma pressure before decompression, and mean arterial blood pressure during decompression had no significant effect on the occurrence of hyperemia. CONCLUSION:In elderly patients, rapid decompression of CSH frequently results in transient hyperemia in the cerebral cortex beneath the hematoma.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Ogasawara K,Koshu K,Yoshimoto T,Ogawa A

doi

10.1097/00006123-199909000-00014

keywords:

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

484-8; discussion 488-9

issue

3

eissn

0148-396X

issn

1524-4040

journal_volume

45

pub_type

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