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
Neurosurgeryjournal_title
Neurosurgeryauthors
Ogasawara K,Koshu K,Yoshimoto T,Ogawa Adoi
10.1097/00006123-199909000-00014keywords:
subject
Has Abstractpub_date
1999-09-01 00:00:00pages
484-8; discussion 488-9issue
3eissn
0148-396Xissn
1524-4040journal_volume
45pub_type
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