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Paradoxical Herniation after Decompressive Craniectomy for Acute Subdural Hematoma  

Cho, Hyun (Department of Neurosurgery, School of Medicine, Hanyang University, Guri Hospital)
Kim, Choong-Hyun (Department of Neurosurgery, School of Medicine, Hanyang University, Guri Hospital)
Kim, Jae-Hoon (Department of Neurosurgery, School of Medicine, Hanyang University, Guri Hospital)
Kim, Jae-Min (Department of Neurosurgery, School of Medicine, Hanyang University, Guri Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.40, no.1, 2006 , pp. 51-53 More about this Journal
Abstract
Decompressive craniectomy is usually performed to relieve raised intracranial pressure[ICP] caused by various intracranial lesions. A 67-year-old man presented with acute subdural hematoma and traumatic intracerebral hematoma. The patient underwent a decompressive craniectomy. Four weeks later, the patient presented with acute neurological deterioration. Brain computed tomographic[CT] scans revealed the marked concavity of the brain at the site of the craniectomy and associated with midline shift which was reversed by cranioplasty. We report an unusual case of cerebral herniation from intracranial hypotension after decompressive craniectomy for a traumatic subdural hematoma. The cranioplasty may be helpful to prevent paradoxial cerebral herniation.
Keywords
Cerebral herniation; Cranioplasty; Decompressive craniectomy; Subdural hematoma;
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1 Cushing H : The third circulation in studies in intracranial physiology and surgery, ed1. London : Oxford University Press, 1926, pp1-51
2 Komotar RJ, Mocco J, Ransom ER, Mack WJ, Zacharia BE, Wilson DA, et al : Herniation secondary to critical postcraniotomy cerebrospinal fluid hypovolemia. Neurosurgery 57 : 286-292, 2005   DOI   ScienceOn
3 Liao CC, Kao MC : Cranioplasty for patients with severe depressed skull bone defect after cerebrospinal fluid shunting. J Clin Neurosci 9 : 553- 555, 2002   DOI   ScienceOn
4 Yoo DS, Kim DS, Huh PW, Cho KS, Park CK, Kang JK : Intracranial pressure and cerebral blood flow monitoring after bilateral decompressive craniectomy in patients with acute massive brain swelling. J Korean Neurosurg Soc 30 : 295-306, 2001
5 Langfitt TW : Increased intracranial pressure. Clin Neurosurg 16 : 436- 471, 1968
6 Gardner WJ : Closure of defects of the skull with tantallum. Surg Gynec Obstet 80 : 303-312, 1945
7 Tabaddor K, LaMorgese J : Complications of large cranial defects. J Neurosurg 44 : 506-508, 1976   DOI
8 Segal DH, Oppenheim JS, Murovic JA : Neurosurgical recovery after cranioplasty. Neurosurgery 34 : 729-731, 1994   DOI   ScienceOn
9 Fodstad H, Love JA, Ekstedt JE, Frieden H, Liequist BL : Effects of cranioplasty on cerebrospinal fluid hydrodynamics in patients with syndrome of the trephined. Acta Neurochir 70 : 21-30, 1984   DOI
10 Stula D : Intracranial pressure measurement in large skull defects. Neurochirurgia 28 : 164-169, 1985
11 Schwab S, Erbuguth F, Aschoff A, Orberk E, Spranger M, Hacke W : Paradoxical herniation after decompressive trephining. Nervenarzt 69 : 896-900, 1998   DOI
12 Oyelese AA, Steinberg GK, Huhn SL, Wijman CA : Paradoxical herniation secondary to lumbar puncture after decompressive craniectomy for a large space-occupying hemisphere stroke : case report. Neurosurgery 57 : 594, 2005   DOI
13 Yamamura A, Makino H : Neurologic deficit following craniectomy. J Neurosurg 45 : 362, 1976
14 Richaud J, Boetto S, Guell A, Lazorthes Y : Effects of cranioplasty on neurological function and cerebral blood flow. Neurochirurgie 31 : 183-188, 1985
15 Kelley GR, Johnson PL : Sinking brain syndrome : craniotomy can precipitate brainstem herniation in CSF hypovolemia. Neurology 62 : 157, 2004   DOI
16 Schiffer J, Gur R, Nisim U, Pollak L : Symptomatic patients after craniectomy. Surg Neurol 47 : 231-237, 1997   DOI   ScienceOn