Contralateral subdural effusion following decompressive hinged craniotomy: A case report and narrative review

Area of Science:

• Neurosurgery
• Critical Care Medicine

Background:

• Hinged craniotomy (HC) is an alternative to decompressive craniectomy (DC) for refractory intracranial hypertension.
• HC offers advantages in controlling intracranial pressure and avoiding a second surgery for bone replacement.
• Literature on HC complications, particularly contralateral subdural effusion (CSE), is inconsistent.

Purpose of the Study:

• To report a case of contralateral subdural effusion (CSE) after hinged craniotomy (HC).
• To discuss the management of CSE in this context.
• To explore the pathogenesis, treatment, and prevention of CSE after HC.

Main Methods:

• Case report of a 55-year-old male patient.
• Review of existing literature on hinged craniotomy complications and subdural effusions.
• Analysis of the patient's clinical presentation and management.

Main Results:

• The patient developed contralateral subdural effusion (CSE) post-hinged craniotomy (HC).
• The effusion was successfully managed.
• Literature review highlighted a lack of reported CSE cases post-HC.

Conclusions:

• Contralateral subdural effusion (CSE) is a potential, albeit rare, complication of hinged craniotomy (HC).
• Further research is needed to understand CSE pathogenesis and establish prevention strategies.
• This case underscores the importance of vigilance for atypical complications after HC.