Intraoperative supratentorial extradural haematoma complicating excision of a giant vestibular schwannoma.

Intraoperative supratentorial extradural haematoma complicating excision of a giant vestibular schwannoma.

World Neurosurg. 2016 Jan 21;

Authors: Lewis DG, Lloyd S, Pathmanaban ON, Ward C, Rutherford SA, King AT

Abstract
BACKGROUND: Here we present the case of a man, who developed a rare and unexpected contralateral intraoperative complication during a translabyrinthine resection of a large cystic vestibular schwannoma.
CASE DESCRIPTION: A 29 year old gentleman, presented with progressive low-level right sided tinnitus and hearing loss. Subsequent MR imaging displayed a large multi-cystic lesion suggestive of a vestibular schwannoma extending into the right cerebellopontine angle and distorting the midbrain. The patient subsequently underwent translabyrinthine excision of this lesion. The operation was, however, complicated by brain swelling that obscured the operative field. CSF drainage failed to improve operative conditions, therefore an urgent CT scan was perfomed, which showed a large supratentorial extradural haematoma as the cause. This extradural collection was promptly evacuated, and the patient made a good postoperative neurological recovery.
CONCLUSIONS: Whilst the development of postoperative extradural haematomas due to CSF overdrainage, is reported in the literature, this case is unique in that infratentorial surgery led to the development of a supratentorial haematoma.

PMID: 26805692 [PubMed - as supplied by publisher]

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