Case-control Study Of Contralateral Hematoma Secondary To Decompressive Craniectomy For Severe Head Trauma

Background:Contralateral hematoma is an infrequent but severe complication of decompressive craniectomy for head trauma.Method:We performed a retrospective case-control study of patients developing this complication after decompressive craniectomy for head trauma in our institute. Demographics, mechanism of trauma, pre-operation GCS, CT features before decompressive craniectomy, and patients’ outcomes were recorded for further analysis.Results:Sixteen patients developed this complication in the study; most had epidural hematomas, which appeared within the first12hours after decompressive craniectomy in14patients, including three hematomas that developed during surgical decompression. Contralateral cranial fracture is a major risk factor for this condition. The outcomes between case group and control group have no significant difference.Conclusion:The prompt detection and removal of the hematoma are keys to management of contralateral hematoma secondary to surgical decompression, and we recommend immediately recurrent computed tomography after the first operation with existence of a contralateral skull fracture.