Posttraumatic Triple Acute Epidural Hematomas: First Report of Bilateral Synchronous Epidural Hematoma and a Third Delayed.
Delayed epidural hematoma
Epidural hematoma
Head injury
Skull fractures
Traumatic brain injury
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
12
08
2019
revised:
30
09
2019
accepted:
01
10
2019
pubmed:
13
10
2019
medline:
28
1
2020
entrez:
13
10
2019
Statut:
ppublish
Résumé
Development of a delayed acute epidural hematoma (DEDH) represents a rare event, characterized by a high mortality rate. It is defined as an extradural bleeding not evident at the first brain computed tomography (CT) scan performed after traumatic brain injury but evidenced by further radiologic evaluations. A 22-year-old male was admitted to our unit after brain injury due to an assault. Immediate brain CT scan revealed a right frontal epidural hematoma (EDH) and a smaller left anterior temporal EDH with multiple, bilateral skull fractures in the frontal, parietal, and temporal bones. Both EDHs were surgically treated in the same session. Another immediate CT scan showed a third left parietal acute DEDH. The patient was retransferred to the operating room for a further left parietal craniotomy and EDH evacuation. The postoperative period was uneventful: the patient effectively improved. After 15 days, the patient left the hospital and was admitted to a rehabilitation center. To the best of our knowledge, this is the first report of a synchronous acute bilateral EDH with the development of a third DEDH located in a separate site. This finding is certainly related to the presence of multiple and bilateral skull fractures. In our experience, we suggest performing an intraoperative CT scan, if available, to early detect the possible development of DEDH.
Sections du résumé
BACKGROUND
BACKGROUND
Development of a delayed acute epidural hematoma (DEDH) represents a rare event, characterized by a high mortality rate. It is defined as an extradural bleeding not evident at the first brain computed tomography (CT) scan performed after traumatic brain injury but evidenced by further radiologic evaluations.
CASE DESCRIPTION
METHODS
A 22-year-old male was admitted to our unit after brain injury due to an assault. Immediate brain CT scan revealed a right frontal epidural hematoma (EDH) and a smaller left anterior temporal EDH with multiple, bilateral skull fractures in the frontal, parietal, and temporal bones. Both EDHs were surgically treated in the same session. Another immediate CT scan showed a third left parietal acute DEDH. The patient was retransferred to the operating room for a further left parietal craniotomy and EDH evacuation. The postoperative period was uneventful: the patient effectively improved. After 15 days, the patient left the hospital and was admitted to a rehabilitation center.
CONCLUSIONS
CONCLUSIONS
To the best of our knowledge, this is the first report of a synchronous acute bilateral EDH with the development of a third DEDH located in a separate site. This finding is certainly related to the presence of multiple and bilateral skull fractures. In our experience, we suggest performing an intraoperative CT scan, if available, to early detect the possible development of DEDH.
Identifiants
pubmed: 31605850
pii: S1878-8750(19)32624-5
doi: 10.1016/j.wneu.2019.10.009
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
212-215Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.