Postoperative extradural hematoma after removal of a subgaleal drainage catheter--case report

A 29-year-old man developed a delayed postoperative extradural hematoma after the craniotomy to treat recurrent malignant glioma and hydrocephalus. The patient became alert on the day after the operation. Computed tomography (CT) 12 hours after the operation showed no intracranial hematoma and the subgaleal drainage catheter was removed 18 hours after the operation. The patient complained of headache and went into a coma 2 hours after removal of the drain. CT demonstrated massive acute extradural hematoma with marked midline shift. Emergency craniotomy revealed that the source of the hematoma was an injured scalp artery along the route of the drainage catheter. He died of acute brain edema 9 days later. Hemostasis should be confirmed at insertion and removal of the drainage catheter.