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CC BY 4.0 · Indian Journal of Neurosurgery 2024; 13(01): 081-083
DOI: 10.1055/s-0043-1776018
Letter to Editor

Remote Site Hemorrhage following Evacuation of Left Fronto-Temporo-Parietal Subdural Hematoma: A Rare Case Report and Comprehensive Literature Review

Darpanarayan Hazra 
1   Department of Emergency Medicine, Institute of Neurosciences, Kolkata, West Bengal, India
,
Gina Maryann Chandy 
2   Department of Emergency Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
,
Amit Ghosh
3   Department of Neurosurgery, Institute of Neurosciences, Kolkata, West Bengal, India
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Abstract

This report presents a compelling case of remote site hemorrhage (RSH), a rare but severe complication associated with neurosurgery. RSH involves cerebral bleeding away from the surgical site and was first documented in 1937 by Van Gehuchten. Despite its rarity, RSH remains challenging, affecting less than 1% of cases, with an unclear cause. The case involves a 67-year-old male who developed severe symptoms within 24 hours post-surgery. The initial computed tomography scan showed an acute subdural hematoma. Surgical evacuation was followed by rapid deterioration, leading to multiple RSH and brain stem infarctions. Unfortunately, the patient did not survive. RSH poses significant morbidity and mortality risks. Potential factors include volume loss, dural opening, and blood pressure fluctuations. Management ranges from conservative approaches to surgery, with poor prognosis post-RSH intervention. This case highlights the need for thorough preoperative assessment and careful intraoperative management. It emphasizes the complexities of neurosurgery and underscores the importance of ongoing research for managing rare complications like RSH, ultimately improving patient outcomes.

Keywords

neurosurgery - remote site hemorrhage - RSH - SDH

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient's relatives has given their consent for the patient's images and other clinical information to be reported in the journal. The patient's relatives understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.


Data Availability Statement

It can be made available as per the reader's request.




Publication History

Article published online:
17 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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