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Subdural hematoma following open-heart operations.
The Annals of Thoracic Surgery
|March 1, 1975
Summary
Open-heart surgery patients may develop acute subdural hematomas due to heparin and head trauma. Careful head manipulation is crucial, especially in infants, to prevent brain bleeds.
Area of Science:
- Neurosurgery
- Cardiovascular Surgery
- Pathology
Background:
- Postmortem examinations revealed acute subdural hematomas in six patients after open-heart operations.
- This finding suggests a potential complication linked to cardiac surgical procedures.
Purpose of the Study:
- To investigate the pathogenesis of acute subdural hematomas in patients undergoing open-heart surgery.
- To identify risk factors and propose preventive measures.
Main Methods:
- Clinical case review and postmortem examination findings were analyzed.
- Pathogenesis of subdural hematoma formation was postulated based on observed factors.
Main Results:
- Intraoperative heparin administration combined with minor head trauma or fluid-shift-induced cerebral volume changes can lead to significant subdural hematoma.
- Bridging dural veins are susceptible to damage under these conditions.
Conclusions:
- Extreme caution during head manipulation is advised for patients receiving heparin, particularly infants.
- Expanding subdural hematoma should be considered in post-open-heart surgery patients with neurological dysfunction.