Intracerebral hematoma after evacuation of chronic subdural hematoma

A case of intracerebral hemorrhage occurring after evacuation of a chronic subdural hematoma is presented. The mechanism of this complication is not clear. However, hemorrhage into previously undetected areas of contusion, damage to cerebral vasculature secondary to rapid perioperative parenchymal shift, and sudden increase in cerebral blood flow with focal disruption of autoregulation have been postulated as causes. Although this is a rare complication after decompressive operation for chronic subdural hematoma, it should be suspected and investigated without delay in patients who deteriorate postoperatively.