Insertion of the subduro-peritoneal drainage in a patient with recurrent bilateral subdural hygroma: a case report

  • Janez Ravnik
  • Domagoj Jugović
  • Andrej Vranič
Keywords: subdural hygroma, craniocerebral trauma, recurrence, treatment, subduro-peritoneal drainage

Abstract

Background: Subdural hygroma is collection of the cerebrospinal-like fluid in the subdural space. It is usually asymptomatic. Sometimes gradual increase is noted which acts tensionally and causes pressure on the brain structures. It this case surgical treatment is necessary which is usually straightforward.

Results: In the paper a case of a patient is presented where after craniocerebral injury bilateral symptomatic subdural hygroma developed. He was first treated with insertion of bilateral subdural drainage and then with repeated subdural taps. After both therapeutic measures the hygroma always recurred with worsening of the clinical condition. For permanent resolution of the hygroma an insertion of the subduro-peritoneal drainage was needed. After this operation the patient fully recovered. Two months after the operation he is without problems and the hygroma did not recur.

Conclusions: This case report proves that in recurrent subdural hygroma insertion of the subduro-peritoneal drainage is a good treatment option. Unilateral drainage could be beneficial even in bilateral hygroma.

Downloads

Download data is not yet available.

References

Traumatic subdural hygroma. In: Greenberg MS, ed. Handbook of neurosurgery, 6th ed. New York: Thieme Medical Publishers; 2006. p. 677–8.

Deltour P, Lemmerling M, Bauters W, Siau B, Kunnen M. Posttraumatic subdural hygroma: CT findings and differential diagnosis. JBR-BTR 1999; 82: 155–6.

Lee KS. The pathogenesis and clinical significance of traumatic subdural hygroma. Brain Inj 1998; 12: 595–603.

Stone JL, Lang RG, Sugar O, Moody RA. Traumatic subdural hygroma. Neurosurgery 1981; 8: 542–50.

Wetterling T, Demierre B, Rama B, Nekic M. Protein analysis of subdural hygroma fluid. Acta Neurochir 1988; 91: 79–82.

Lang JK, Ludwig HC, Mursch K, Zimmerter B, Markakis E. Elevated cerebral perfussion pressure and low colloid osmotic pressure as a risk factor for subdural space-occupying hygromas? Surg Neurol 1999; 52: 630–7.

Park CK, Choi KH, Kim MC, Kang JK, Choi CR. Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma. Acta Neurochir 1994; 127: 41–7.

Lee KS, Bae WK, Doh JW, Bae HG, Yun IG. Origin of chronic subdural haematoma and relation to traumatic subdural lesions. Brain Inj 1998; 12: 901–10.

Ohno K, Suzuki R, Masaoka H, Matsushima Y, Inaba Y, Monma S. Chronic subdural haematoma preceded by persistent traumatic subdural fluid collection. J Neurol Neurosurg Psychiatry 1987; 50: 1694–7.

Huh PW, Yoo DS, Cho KS, Park CK, Kang SG, Park YS, et al. Diagnostic method for differentiating external hydrocephalus from simple subdural hygroma. J Neurosurg 2006; 105: 65–70.

Prabhu SS, Zauner A, Bullock MRR. Surgical management of traumatic brain injury. In: Winn HR, ed. Youmans neurological surgery. 5th ed. Philadelphia: Saunders; 2004. p. 5145–80.

Weigel R, Schmidek P, Krauss JK. Outcome of contemporary surgery for chronic subdural haematoma: evidence based review. J Neurol Neurosurg Psychiatry 2003; 74: 937–43.

Probst C. Peritoneal drainage of chronic subdural hematomas in older patients. J Neurosurg 1988; 68: 908–11.

Caldarelli M, Di Rocco C, Romani R. Surgical treatment of chronic subdural hygromas in infants and children. Acta Neurochir 2002; 144: 581–8.

Misra M, Salazar JL, Bloom DM. Subduro-peritoneal shunt: treatment for bilateral chronic subdural hematoma. Surg Neurol 1996; 46: 378–83.

How to Cite
1.
Ravnik J, Jugović D, Vranič A. Insertion of the subduro-peritoneal drainage in a patient with recurrent bilateral subdural hygroma: a case report. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];76(10). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1901
Section
Case report