Inteacerebral and Brain Stem Hemorrhage Following Evacuation of Chronic Subdural Hematoma and Hygroma

ABSTRACT

Two cases of intracerebral and brain stem hemorrhage occurring after evacuation of chronic subdural hematoma and subdural hygroma are reported. A patient who had undergone craniotomy with closed drainage for subdural hygroma had intracerbral and fatal brain stem hemorrhage in the immediate postoperative period. Despite rapid and intensive treatment, he died. The other patient had intracerebral hematoma following drainage of chronic subdural hematoma and left with severe disability. Possible pathogenic mechanisms leading to development of the postoperative intraparenchymal hemorrhage are suggested. Sudden increase in cerebral blood flow combined with defective autoregulation seemed the most likely pathogenic mechanism to be responsible for the postoperative hemorrhage. If close neurosurgical observation of patients and clinical awareness for the intraparenchymal hemorrhage after evacuation of chronic extracerebral fluid collections given, this devastating complication may be avoided.