Summary
A case is reported of a woman of 32 with external hydrocephalus, presumably due to sinus thrombosis. One hour after ventriculography, carried out under local anaesthesia through posterior burr-holes, signs of an extradural haematoma developed. The Patient was re-x-rayed and a marked shift to the right of the anterior ventricular system was displayed. Through a left frontal flap a large extradural haematoma was evacuated. The patient made a full recovery.
The possible explanation for this unusual complication, and similar cases in the literature are discussed.
Zusammenfassung
Fallbericht über eine 32jährige Frau mit Hydrozephalus externus, wahrscheinlich bedingt durch eine Sinusthrombose. Eine Stunde nach einer Ventrikulographie, die unter Lokalanaesthesie von hinteren Bohrlöchern aus vorgenommen wurde, traten die Zeichen eines extraduralen Hämatoms auf. Erneute Röntgenaufnahmen zeigten eine deutliche Verlagerung der vorderen Ventrikelabschnitte nach rechts. Von einer links frontalen osteoplastischen Trepanation aus wurde ein großes extradurales Hämatom entleert. Volle Heilung.
Die mögliche Erklärung dieser ungewöhnlichen Komplikation sowie ähnliche Fälle des Schrifttums werden besprochen.
Résumé
Les auteurs rapportent l'observation d'une femme de 32 ans hospitalisée pour hydrocéphalie externe liée probablement à une thrombose du sinus. Une heure après la ventriculographie par trous de trépan postérieurs, pratiquée sous anesthésie locale, apparaissent des signes d'hématome extra-dural. Les clichés montrent une forte déviation vers le côté droit du système ventriculaire antérieur. On évacue l'hématome extra-dural par trépanation frontale gauche. La malade récupère entièrement.
Le mécanisme possible de cette complication particulière et des cas semblables retrouvés dans la littérature est discuté.
Riassunto
Viene descritto il caso di una donna di 32 anni con idrocefalo esterno, presumibilmente dovuto a trombosi del seno. Un'ora dopo la ventricolografia, condotta in anestesia locale sono comparsi segni di ematoma extradurale. La paziente è stata immediatamente sottoposta ad un nuovo esame radiografico ed è stata constatata la presenza di un marcato spostamento verso destra del sistema ventricolare anteriore. Attraverso un lembo frontale è stato evacuato un vasto ematoma extradurale. Le paziente è guarita prontamente.
La possibile spiegazione di questa complicazione inusuale e di casi simili della letteratura viene discussa.
Resumen
Los autores refieren la observación de una enferma de 32 años hospitalizada por una hidrocefalie externa asociada probablemente a una trombosis del seno. Una hora después de la ventriculografía, por agujeros de trépano posteriores, practicada bajo anestesia local, aparecen signos de hematoma extradural. Las radiografías demuestran una gran desviación hacia el lado derecho del sistema ventricular anterior. Se vacia el hematoma extradural a través de un trépano frontal izquierdo. La enferma se recupera totalmente.
Se discute el posible mecanismo de esta complicación y de los casos similares hallados en la literatura.
Similar content being viewed by others
References
Anderson, F. M., Subdural hematoma, a complication of operation for hydrocephalus. Pediatrics10 (1952), 11–18.
Bell, C, cited byCarter.
Carter, A. E., Extradural Haemorrhage in a child without skull Fracture, Following Minor Trauma. J. Neurosurg.17 (1960), 155–156.
Connolly, C., Intracranial haematoma concealed by leakage of cerebrospinal fluid. Brit. med. J.2 (1956), 1154–1156.
Davidoff, L. M., andE. H. Feiring, Subdural hematoma occuring in surgically treated hydrocephalic children. With a note on a method of handling persistant accumulation. J. Neurosurg.10 (1953), 557–563.
Ford, L. E., andR. L. McLaurin, Mechanisms of extradural hematomas. J. Neurosurg.20 (1963), 760–769.
Haft, H., H. Liss andL. A. Mount, Massive epidural hemorrhage as a complication of ventricular drainage. J. Neurosurg.17 (1960), 49–54.
Luys, G., Les blessures des sinus de la dure-mère. Pr. med9 (1901), 278–281.
Peet, M. M., Extradural hematoma, subdural hematoma subdural hygroma. In: Injuries of the skull, brain and spinal cord. Neuropsychiatric, Surgical and Medico-legal aspects. S. Brock. Ed. Baltimore Williams & Wilkins Co. (1940), 135–159.
Schorstein, J., Fatal intracranial venous haematoma following ventricular drainage. J. Neurol. Psychiat,5 (1942), 142–147.
Youmans, J. R., andR. C. Schneider, Post-traumatic intracranial hematomas in patients with arrested hydrocephalus. J. Neurosurg.17 (1960), 590–597.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ameli, N.O., Sodeify, N. Anterior fossa extradural haematoma following ventriculography through posterior burr-holes. Acta neurochir 13, 464–468 (1965). https://doi.org/10.1007/BF02074428
Issue Date:
DOI: https://doi.org/10.1007/BF02074428