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Massive Pontine Hemorrhage by Dual Injection of Autologous Blood
Published on: May 29, 2021
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Bilateral assymetric epidural hematoma.
Edmundo Luis Rodrigues Pereira1, Daniella Brito Rodrigues2, Lorena Oliveira Lima1
1Neurosurgeon, Department of Neurological Surgery, Metropolitan Hospital of Urgencies and Emergencies, Belém, PA, Brazil.
Surgical Neurology International
|February 7, 2015
Summary
Acute bilateral extradural hematomas are rare but serious head injuries. Simultaneous surgical drainage effectively reduces intracranial pressure and neurological damage, leading to good patient outcomes.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Emergency Medicine
Background:
- Acute bilateral extradural hematoma is a rare consequence of head trauma, accounting for 0.5-10% of all extradural hematomas.
- Previous case series have indicated a higher mortality rate associated with this condition.
Observation:
- A 28-year-old male presented with severe head injury, coma (Glasgow Coma Scale of 6), and unequal pupils unresponsive to light.
- Computed tomography revealed asymmetric bilateral epidural hematomas, effacement of ventricles and sulci, midline shift, and a bilateral vertex skull fracture.
Findings:
- Surgical evacuation and simultaneous drainage of both hematomas were performed.
- The patient recovered without neurological deficits and was discharged on the 29th postoperative day.
Implications:
- The management strategy for bilateral epidural hematomas should consider hematoma volume, diagnostic timing, and neurological status.
- Simultaneous bilateral hematoma drainage is an effective surgical technique for rapidly decreasing intracranial pressure and improving neurological recovery.
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