Brain herniation induced by drainage of subdural hematoma in spontaneous intracranial hypotension
Spontaneous intracranial hypotension (SIH), typically presents with orthostatic headache, low pressure on lumbar tapping, and diffuse pachymeningeal enhancement on magnetic resonance imaging. SIH is often accompanied by subdural fluid collections, which in most cases responds to conservative treatment or spinal epidural blood patch. Several authors advocate that large subdural hematoma with acute deterioration merits surgical drainage; however, few have reported complications following craniotomy. We describe a complicated case of SIH, which was initially diagnosed as acute subarachnoid hemorrhage with bilateral chronic subdural hematoma (SDH), due to unusual presentation. Burr hole drainage of subdural hematoma was performed due to progressive decrease of consciousness, which then resulted in a huge postoperative epidural hematoma collection. Prompt hematoma evacuation did not restore the patient's consciousness but aggravated downward brain herniation. Trendelenburg position and spinal epidural blood patch achieved a rapid improvement in patient's consciousness. This case indicates that the surgical drainage for chronic SDH in SIH can lead to serious complications and it should be cautiously considered.
- Location
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Deutsche Nationalbibliothek Frankfurt am Main
- Extent
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Online-Ressource
- Language
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Englisch
- Bibliographic citation
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Brain herniation induced by drainage of subdural hematoma in spontaneous intracranial hypotension ; volume:8 ; number:02 ; year:2013 ; pages:112-115
Asian journal of neurosurgery ; 8, Heft 02 (2013), 112-115
- Contributor
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Chotai, Silky
Kim, Jong-Hyun
Kim, Joo Han
Kwon, Taek Hyun
- DOI
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10.4103/1793-5482.116390
- URN
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urn:nbn:de:101:1-2022120112220185767611
- Rights
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Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Last update
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15.08.2025, 7:27 AM CEST
Data provider
Deutsche Nationalbibliothek. If you have any questions about the object, please contact the data provider.
Associated
- Chotai, Silky
- Kim, Jong-Hyun
- Kim, Joo Han
- Kwon, Taek Hyun
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