Acute Contralateral Epidural Hematoma Developing during Decompressive Surgery for Traumatic Intracranial Hematoma

Report of Three Cases

Abstract

Three cases of acute epidural hematoma which developed on the opposite side during decompressive surgery for traumatic intracranial hematomas, such as, acute subdural hematoma, brain contusion or acute epidural hematoma, are presented.
Each case had a skull fracture or a diastasis of the cranial suture contralateral to the decompressive craniotomy, which might have injured the dural artery. During or immediately after decompressive operations, sudden bulging of the brain was unexpectedly encountered. It was suspected that bleeding of the injured dural artery ensued from the abrupt release of the mass effect caused by the intracranial hematoma.
Since deviation and distortion of the brain stem would be more rapid and more intense under such circumstances, operative evacuation of the contralateral epidural hematoma should be urgently carried out.