Sudden worsening after subdural haematoma surgery: will there be a corpus callosum injury?
Identifieur interne : 001961 ( PubMed/Corpus ); précédent : 001960; suivant : 001962Sudden worsening after subdural haematoma surgery: will there be a corpus callosum injury?
Auteurs : Pier Paolo Panciani ; Elena Roca ; Giovanni Lodoli ; Marco Maria FontanellaSource :
- BMJ case reports [ 1757-790X ] ; 2014.
English descriptors
- KwdEn :
- Brain Edema (diagnosis), Brain Edema (etiology), Corpus Callosum (pathology), Diffusion Magnetic Resonance Imaging, Hematoma, Subdural, Chronic (complications), Hematoma, Subdural, Chronic (diagnostic imaging), Hematoma, Subdural, Chronic (surgery), Humans, Magnetic Resonance Imaging, Male, Middle Aged, Tomography, X-Ray Computed.
- MESH :
- complications : Hematoma, Subdural, Chronic.
- diagnosis : Brain Edema.
- diagnostic imaging : Hematoma, Subdural, Chronic.
- etiology : Brain Edema.
- pathology : Corpus Callosum.
- surgery : Hematoma, Subdural, Chronic.
- Diffusion Magnetic Resonance Imaging, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Tomography, X-Ray Computed.
Abstract
We report a case of mild encephalopathy with a reversible splenial lesion (MERS) which occurred after chronic subdural haematoma (CSDH) surgery. The patient was admitted to our hospital for drowsiness and marked asthenia. The cerebral CT scan revealed a CSDH and surgery allowed to improve the symptoms, but after several days we observed a sudden worsening. The patient developed left-sided myoclonic seizures followed by left hemiplegia and worsening drowsiness. Electrolytes imbalance and inflammatory causes were excluded. The CT scan showed a right cerebral swelling and the subsequent MRI revealed a single lesion in the splenium of the corpus callosum, hyperintense on diffusion-weighted images. After osmotic therapy the patient improved and on day 10 of admission the MRI showed a complete resolution of the lesion. This is the first report that described an association between CSDH and MERS. Possible aetiopathogenetic mechanisms are discussed.
DOI: 10.1136/bcr-2013-203278
PubMed: 24862419
Links to Exploration step
pubmed:24862419Le document en format XML
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<author><name sortKey="Panciani, Pier Paolo" sort="Panciani, Pier Paolo" uniqKey="Panciani P" first="Pier Paolo" last="Panciani">Pier Paolo Panciani</name>
<affiliation><nlm:affiliation>Department of Neuroscience, Division of Neurosurgery, University of Brescia, Brescia, Italy.</nlm:affiliation>
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<author><name sortKey="Roca, Elena" sort="Roca, Elena" uniqKey="Roca E" first="Elena" last="Roca">Elena Roca</name>
<affiliation><nlm:affiliation>Department of Neuroscience, Division of Neurosurgery, University of Brescia, Brescia, Italy.</nlm:affiliation>
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<author><name sortKey="Lodoli, Giovanni" sort="Lodoli, Giovanni" uniqKey="Lodoli G" first="Giovanni" last="Lodoli">Giovanni Lodoli</name>
<affiliation><nlm:affiliation>Department of Neuroscience, Division of Diagnostic Imaging, University of Brescia, Brescia, Italy.</nlm:affiliation>
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<author><name sortKey="Fontanella, Marco Maria" sort="Fontanella, Marco Maria" uniqKey="Fontanella M" first="Marco Maria" last="Fontanella">Marco Maria Fontanella</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brain Edema (diagnosis)</term>
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<term>Corpus Callosum (pathology)</term>
<term>Diffusion Magnetic Resonance Imaging</term>
<term>Hematoma, Subdural, Chronic (complications)</term>
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<term>Hematoma, Subdural, Chronic (surgery)</term>
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<term>Magnetic Resonance Imaging</term>
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<front><div type="abstract" xml:lang="en">We report a case of mild encephalopathy with a reversible splenial lesion (MERS) which occurred after chronic subdural haematoma (CSDH) surgery. The patient was admitted to our hospital for drowsiness and marked asthenia. The cerebral CT scan revealed a CSDH and surgery allowed to improve the symptoms, but after several days we observed a sudden worsening. The patient developed left-sided myoclonic seizures followed by left hemiplegia and worsening drowsiness. Electrolytes imbalance and inflammatory causes were excluded. The CT scan showed a right cerebral swelling and the subsequent MRI revealed a single lesion in the splenium of the corpus callosum, hyperintense on diffusion-weighted images. After osmotic therapy the patient improved and on day 10 of admission the MRI showed a complete resolution of the lesion. This is the first report that described an association between CSDH and MERS. Possible aetiopathogenetic mechanisms are discussed. </div>
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<Abstract><AbstractText>We report a case of mild encephalopathy with a reversible splenial lesion (MERS) which occurred after chronic subdural haematoma (CSDH) surgery. The patient was admitted to our hospital for drowsiness and marked asthenia. The cerebral CT scan revealed a CSDH and surgery allowed to improve the symptoms, but after several days we observed a sudden worsening. The patient developed left-sided myoclonic seizures followed by left hemiplegia and worsening drowsiness. Electrolytes imbalance and inflammatory causes were excluded. The CT scan showed a right cerebral swelling and the subsequent MRI revealed a single lesion in the splenium of the corpus callosum, hyperintense on diffusion-weighted images. After osmotic therapy the patient improved and on day 10 of admission the MRI showed a complete resolution of the lesion. This is the first report that described an association between CSDH and MERS. Possible aetiopathogenetic mechanisms are discussed. </AbstractText>
<CopyrightInformation>2014 BMJ Publishing Group Ltd.</CopyrightInformation>
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