Rapid Evacuation of Chronic Subdural Hematoma - A Possible Traumatic Brain Injury (TBI).
Medical hypotheses(2020)
Abstract
The chronic subdural hematoma is an entity, which affects mainly the elderly patients. According to literature, the complication rate was up to 22,7%, including recurrence of hematoma, worsening of the neurological status, postoperative delirium, etc. Treating of a chronic subdural hematoma could be conservative and operative, including twist drill craniostomy, single or multiple burr hole drainage, and craniotomy. In the patients who underwent a decompression of the hematoma a postoperative hyperperfusion syndrome could be observed, according to literature up to 51,4%. This syndrome is associated risk of postoperative delirium and neurological deterioration. The hyperperfusion syndrome is also observed in traumatic brain injury. A rapid decompression of a subdural hematoma leads to a brain shifting to the skull bones and thus a traumatic brain injury due to decompression. The development of the hyperperfusion syndrome could be related to the decompression of the subdural hematoma in a rapid fashion.
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