• World Neurosurg · Jul 2019

    Bilateral oculomotor palsy after surgical evacuation of chronic subdural hematoma.

    • Luca Zavatto, Federica Marrone, Mario Allevi, Alessandro Ricci, and Graziano Taddei.
    • Department of Neurosurgery, San Salvatore Hospital, L'Aquila, Italy; Department of Life, Health & Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
    • World Neurosurg. 2019 Jul 1; 127: 241-244.

    BackgroundChronic subdural hematoma is a common neurosurgical disease and the most benign form of intracranial hematoma. Most patients are successfully treated with simple burr hole evacuation and external drainage with good outcome and low rate of complications. Brainstem hemorrhage is a rare cause of severe disability in these patients, and cannot be ignored.Case DescriptionWe report the first case of bilateral oculomotor palsy due to a midbrain hemorrhage after evacuation of a unilateral chronic subdural hematoma. The relevant literature is also reviewed to better understand the causes of this rare but disabling occurrence and how it can be prevented during and after surgery.ConclusionsNeurosurgeons must have awareness of remote intracerebral hemorrhage after burr hole evacuation of chronic subdural hematoma, and take measures to avoid it during surgery. Our experience and the review of the relevant literature demonstrate that preoperative computed tomography can provide information to identify the patients at major risk.Copyright © 2019 Elsevier Inc. All rights reserved.

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