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Updated: Jan 26, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Bilateral Oculomotor Palsy After Surgical Evacuation of Chronic Subdural Hematoma
Luca Zavatto1, Federica Marrone1, Mario Allevi1
1Department of Neurosurgery, San Salvatore Hospital, L'Aquila, Italy; Department of Life, Health & Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
Background:
Chronic subdural hematoma is a common neurosurgical disease and the most benign form of intracranial hematoma. Most patients are successfully treated with simple burr hole evacuation and external drainage with good outcome and low rate of complications. Brainstem hemorrhage is a rare cause of severe disability in these patients, and cannot be ignored.
Case Description:
We report the first case of bilateral oculomotor palsy due to a midbrain hemorrhage after evacuation of a unilateral chronic subdural hematoma. The relevant literature is also reviewed to better understand the causes of this rare but disabling occurrence and how it can be prevented during and after surgery.
Conclusions:
Neurosurgeons must have awareness of remote intracerebral hemorrhage after burr hole evacuation of chronic subdural hematoma, and take measures to avoid it during surgery. Our experience and the review of the relevant literature demonstrate that preoperative computed tomography can provide information to identify the patients at major risk.
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