A rare complication of chronic subdural hematoma evacuation: brain stem hemorrhage

• Main Authors: Ghassen Gader, Mouna Rkhami, Maher Ben Salem, Mohamed Badri, Kamel Bahri, Ihsèn Zammel
• Format: Article
• Language: English
• Published: London Academic Publishing 2018-09-01
• Series: Romanian Neurosurgery
• Subjects: chronic subdural hematoma evacuation
• Online Access: https://www.journals.lapub.co.uk/index.php/roneurosurgery/article/view/1115

Chronic subdural hematoma (CSDH), which commonly affects the elderly, is one of the most frequent, but also benign neurosurgical pathologies. Burr hole drainage is the standard surgical modality for evacuation of a CSDH. This technique is known to be safe, with low morbidity and mortality rates. However, postoperative complications have occasionally been reported. We report the case of a 70-year-old man who presented a fatal brain stem hemorrhage after burr-hole drainage for unilateral chronic subdural hematoma. Asymmetrical and rapid decompression were thought to be leading to vascular disruption or sudden increase in cerebral blood flow, was probably responsible for the secondary brain stem bleeding. Therefore, a slow rate of evacuation of chronic subdural hematomas, as well as rigorous postoperative reanimation, are recommended in order to prevent serious complications.