慢性硬腦膜下出血進行鑽顱引流手術造成超急性夾膜內出血

Hyperacute intramembranous hemorrhage after burr hole craniostomy for chronic subdural hematoma

鑽顱併封閉系統引流手術是治療慢性硬腦膜下出血患者，一種有效且常見的神經外科手術方式。術後出血可能導致神經功能缺損惡化，是眾所周知但不常見的併發症之一。然而，至今，仍未有鑽孔併封閉系統引流造成原本慢性硬腦膜血塊內膜和外膜間，急性夾膜間出血案例。在這裡，我們報告一例慢性硬腦膜下出血病患者接受鑽顱併封閉系統引流手術治療，造成術後急性夾膜間出血。我們在本文中，討論可能的致病機制並回顧相關文獻。

 

Burr hole craniostomy with closed-system drainage is an effective and common neurosurgical procedure to manage chronic subdural hematoma. Postoperative hem-orrhage, a well-known but infrequent complication, may result in increased neurolog-ical deficits. However, hyperacute intramembranous hemorrhage within the inner and outer membrane of hematoma after burr hole craniostomy with irrigation and closed-system drainage has not been described previously. Herein, we report a case of postoperative spontaneous hyperacute intramembranous hemorrhage after burr hole craniostomy with closed-system drainage to manage a chronic subdural hematoma; we subsequently discuss the possible pathophysiological mechanisms and review the relevant literature.