Neurosurgical Review

, Volume 34, Issue 4, pp 393–407 | Cite as

Postoperative intracranial haemorrhage: a review

  • Marc A. Seifman
  • Phillip M. Lewis
  • Jeffrey V. Rosenfeld
  • Peter Y. K. Hwang


Postoperative haemorrhage (POH) is one of the most serious complications of any cranial neurosurgical procedure and is associated with significant morbidity and mortality. The relative paucity of work investigating this postoperative complication prompted us to undertake a review of the literature, focussing on demographic, clinical, and surgical risk factors. A literature search was undertaken using Ovid MEDLINE (1950–2009) using keywords including craniectomy, craniotomy, neurosurgery, intracranial, reoperation, repeat craniotomy, postoperative, haemorrhage, haematoma, and bleeding. The rates of POH following intracranial procedures reported in the literature vary greatly, and meaningful comparison is difficult. We defined postoperative haemorrhage as that following craniotomy, which is clinically significant and requires surgical evacuation. Risk factors include pre-existing medical comorbidities including hypertension, coagulopathies and haematological abnormalities, intraoperative hypertension and blood loss, certain lesion pathologies including tumours, chronic subdural haematomas, and deficiencies in haemostasis. We conclude by providing recommendations for clinical practice based on the literature reviewed to aid clinicians in the detection and avoidance of POH.


Postoperative Reoperation Craniotomy Haemorrhage Haematoma Bleeding 



This work was supported by the Alfred Hospital Henry O'Hara Surgical Research Award.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Marc A. Seifman
    • 1
  • Phillip M. Lewis
    • 1
  • Jeffrey V. Rosenfeld
    • 1
    • 2
  • Peter Y. K. Hwang
    • 1
    • 2
  1. 1.Department of NeurosurgeryThe Alfred HospitalMelbourneAustralia
  2. 2.Department of SurgeryMonash UniversityMelbourneAustralia

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