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Contralateral subdural effusion after decompressive craniectomy: What is the optimal treatment?
Hui Ling1, Lijun Yang2, Zhaoxu Huang3
1Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310009, China.
Clinical Neurology and Neurosurgery
|September 28, 2021
Summary
Contralateral subdural effusion after decompressive craniectomy (CSEDC) is rare. Early cranioplasty is recommended for symptomatic CSEDC, with CSF shunting for persistent cases or hydrocephalus.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Contralateral subdural effusion after decompressive craniectomy (CSEDC) is a rare complication.
- Optimal treatment strategies for CSEDC remain undetermined.
Purpose of the Study:
- To present 11 cases of CSEDC from a single institution.
- To review English literature to provide an overview of CSEDC management.
Main Methods:
- A retrospective review of 11 institutional cases of CSEDC.
- A comprehensive literature search of PubMed and Google Scholar for studies on subdural hygroma, subdural effusion, and decompressive craniectomy.
Main Results:
- A total of 79 patients (11 institutional, 68 literature) were analyzed.
- Conservative treatment was effective for asymptomatic CSEDC.
- Symptomatic patients undergoing burr hole drainage had high reaccumulation rates (76%), while cranioplasty with subduroperitoneal shunting achieved complete resolution (18.3% of symptomatic cases).
Conclusions:
- Burr hole drainage is a temporary measure for CSEDC.
- Early cranioplasty is recommended for symptomatic CSEDC.
- Cerebrospinal fluid (CSF) shunting may be necessary for unresolved CSEDC or post-cranioplasty hydrocephalus.
