Results of single burr hole drainage for acute subdural hematoma with non-reactive pupil.

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Results of single burr hole drainage for acute subdural hematoma with non-reactive pupil.

Turk Neurosurg. 2012;22(2):196-9

Authors: Yanagawa Y, Sakamoto T

Abstract AIM: To investigate the effects of emergency burr hole drainage for acute subdural hematoma (ASDH) with bilateral non-reactive pupils. MATERIAL AND METHODS: A retrospective study was conducted by reviewing medical records from 1998 to 2007. Patients meeting the following criteria were included: 1) head injury with unconsciousness (Glasgow Coma Scale score 8); 2) bilateral non-reactive pupils on arrival; 3) ASDH with disappearance of basal cistern on computed tomography (CT); and 4) performance of emergency single burr hole drainage. Subjects were divided into survival and non-survival groups. RESULTS: Pupil size on the small side was significantly smaller in the survival group than in the non-survival group. All pupils on the small side in the survival group were 4 mm. CONCLUSION: Emergency burr hole drainage should still be considered in patients with ASDH showing bilateral non-reactive pupils and one pupil 4 mm.

PMID: 22437294 [PubMed - in process]

Simultaneous cranial subarachnoid hemorrhage and spinal subdural hematoma.

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Simultaneous cranial subarachnoid hemorrhage and spinal subdural hematoma.

Turk Neurosurg. 2012;22(3):349-52

Authors: Mete A, Erkutlu I, Akcali A, Mete A

Abstract We report a rare case of simultaneous cranial subarachnoid and spinal subdural hematoma (SDH) in a 42-year-old man who was on Warfarin therapy after cardiac bypass surgery. Computed tomography at presentation revealed a cranial subarachnoid hemorrhage, and spinal Magnetic Resonance Imaging (MRI) showed a spinal SDH extending from the T6 to L5 segments. He had paraparesis due to spinal cord compression. The patient was managed conservatively due to his poor general condition and was infused with intravenous steroid therapy, but he experienced sudden cardiac arrest 5 hours later after being admitted to the hospital. This case is of interest because of its first presentation of spinal subdural hematoma and cranial subarachnoid hemorrhage simultaneously and it is also the second longest vertebral segmental spread in the literature.

PMID: 22665005 [PubMed - in process]

Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report.

Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report.

Turk Neurosurg. 2011 Jan;21(1):94-6

Authors: Turkoglu E, Kazanci B, Karavelioglu E, Sanli M, Kazanci B, Sekerci Z

Lumboperitoneal shunting is widely used for the surgical management of pseudotumor cerebri and other pathologies such as communicating hydrocephalus. Although it is a safe method, it could be associated with complications including subarachnoid hemorrhage, subdural and rarely intracerebral hematoma. A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O. A non-programmable lumboperitoneal shunt with two distal slit valves was inserted due to pseudotumor cerebri. She deteriorated shortly after surgery. Immediate cranial computed tomography scan revealed a right parietal intracerebral hematoma. Development of intracerebral hematoma following lumboperitoneal shunt is a rare complication. We discuss this rare event accompanied by the literature.

PMID: 21294099 [PubMed - indexed for MEDLINE]