Transient Hyperemia Immediately after Rapid Decompression of Chronic Subdural Hematoma

Transient Hyperemia Immediately after Rapid Decompression of Chronic Subdural Hematoma AbstractOBJECTIVE: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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Transient Hyperemia Immediately after Rapid Decompression of Chronic Subdural Hematoma

Transient Hyperemia Immediately after Rapid Decompression of Chronic Subdural Hematoma

Transient Hyperemia Immediately after Rapid Decompression of Chronic Subdural Hematoma Kuniaki Ogasawara, M.D., Keiji Koshu, M.D., Takashi Yoshimoto, M.D., Akira Ogawa, M.D. Department of Neurosurgery (KO, AO), Iwate Medical University, Morioka; Department of Neurosurgery (KK), Kohnan Hospital, Sendai; and Department of Neurosurgery (TY), Tohoku University School of Medicine, Sendai, Japan O BJECTIVE: 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. M ETHODS: 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. C O N C LU SIO N : In elderly patients, rapid decompression of CSH frequently results in transient hyperemia in the cerebral cortex beneath the hematoma. (N eurosurgery 45:484-489, 1999) Key words: Chronic subdural hematoma, Postoperative intracerebral hematoma, Rapid decompression, Single-photon emission computed tomog­ raphy, Transient hyperemia lthough the...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199909000-00014
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE: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

NeurosurgeryOxford University Press

Published: Sep 1, 1999

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