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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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[Chronic subdural hematoma (CSH) complicated by bilateral occipital lobe infarction: two case reports]

Kanae Kudo1, Masato Naraoka, Norihito Shimamura

  • 1Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hiroshaki-city, Aomori, Japan.

No Shinkei Geka. Neurological Surgery
|April 2, 2013
PubMed

Insights

Chronic subdural hematoma (CSH) can lead to severe complications. This study highlights two cases where CSH caused bilateral occipital lobe infarction, resulting in significant neurological deficits despite surgical intervention.

Area of Science:

  • Neurosurgery
  • Neurology
  • Radiology

Background:

  • Chronic subdural hematoma (CSH) is a common neurosurgical condition typically associated with favorable outcomes.
  • Surgical intervention, such as burr hole drainage, is the standard treatment for CSH.

Observation:

  • Two cases of CSH presented with delayed neurological deterioration.
  • Patients exhibited symptoms ranging from headache and impaired consciousness to coma and gait disturbance.
  • Brain CT scans revealed compressed ambient and interpeduncular cisterns, indicative of increased intracranial pressure and herniation.

Findings:

  • Both patients developed bilateral occipital lobe infarction, a rare but severe complication of CSH.
  • The infarction was attributed to central transtentorial herniation secondary to the mass effect of the bilateral CSH.
  • Despite prompt burr hole drainage, patients experienced severe neurological sequelae.

Implications:

  • This case series underscores the potential for CSH to cause devastating neurological injury beyond typical outcomes.
  • Occipital lobe infarction due to herniation highlights the critical importance of timely diagnosis and management of CSH.
  • Neurosurgeons and neurologists should consider this rare complication in patients with CSH presenting with neurological decline.

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