Brain Tumor Res Treat.  2015 Oct;3(2):132-137. 10.14791/btrt.2015.3.2.132.

Remote Postoperative Epidural Hematoma after Brain Tumor Surgery

• Chung HJ
• Park JS
• Park JH
• Jeun SS

• KMID: 2114661
• DOI: http://doi.org/10.14791/btrt.2015.3.2.132

Abstract

A postoperative epidural hematoma (EDH) is a serious and embarrassing complication, which usually occurs at the site of operation after intracranial surgery. However, remote EDH is relatively rare. We report three cases of remote EDH after brain tumor surgery. All three cases seemed to have different causes of remote postoperative EDH; however, all patients were managed promptly and showed excellent outcomes. Although the exact mechanism of remote postoperative EDH is unknown, surgeons should be cautious of the speed of lowering intracranial pressure and implement basic procedures to prevent this hazardous complication of brain tumor surgery.

Keyword

Epidural hemorrhage; Brain neoplasms; Craniotomy; Neurosurgery

MeSH Terms

Brain Neoplasms*
Brain*
Craniotomy
Hematoma*
Humans
Intracranial Pressure
Neurosurgery

Figure

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  Fig. 1 Case 1. A: Preoperative gadolinum-enhanced T1-weighted MRI shows 4.6×3.5 cm sized heterogenously enhancing mass located in the cerebellopontine angle. B: Immediate postoperative brain CT scan shows acute EDHs in bilateral parietal regions (arrows). C: Without any procedure for EDHs, 2 week follow-up CT scan shows no change in the size of EDHs and the density of EDHs has changed. D: Postoperative gadolinum-enhanced T1-weighted MRI shows the tumor gross totally removed. EDH, epidural hematoma.

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  Fig. 2 Case 2. A: Preoperative gadolinum-enhanced T1-weighted MRI shows 2.0×2.0 cm sized heterogenously enhancing mass located in suprasellar area. B: Immediate postoperative brain CT scan shows no specific complications. C: CT scan in 2 postoperative days shows EDH in right parietal area (arrow). D: After 2 weeks follow-up, EDH was resoluted but enlarged. E: After burr hole trephination, EDH was completely evacuated. F: Postoperative gadolinum-enhanced T1-weighted MRI shows the tumor gross totally removed. EDH, epidural hematoma.

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  Fig. 3 Case 3. A: Preoperative gadolinum-enhanced T1-weighted MRI shows 7.8×5.8 cm sized dumbell shaped huge mass involving left cerebellopontine angle, middle cranial fossa and Meckel's cave. B: Immediate postoperative brain CT scan shows acute EDHs (arrow) in bilateral frontal area. C: After craniotomy, EDH was completely evacuated. D: Postoperative gadolinum-enhanced T1-weighted MRI shows the tumor gross totally removed. EDH, epidural hematoma.

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