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KMID : 1143720220180020335
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Korean Journal of Neurotrauma
2022 Volume.18 No. 2 p.335 ~ p.340
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Multiple Cerebral Hemorrhages Caused by Paradoxical Reperfusion Injury After Cranioplasty
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Oh Hyuk-Jin
Shim Jai-Joon
Ahn Jae-Min
Oh Jae-Sang
Yoon Seok-Mann
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Abstract
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Cranioplasty-related reperfusion injury has rarely been reported. Although there are several hypotheses, particularly regarding the mechanisms of the event, clear evidence is lacking. Here, we report the case of an 84-year-old man with traumatic intracranial hemorrhage and subdural hematoma who underwent decompressive craniectomy and hematoma evacuation in the right hemisphere. After 45 days, cranioplasty was performed using titanium. A preoperative perfusion study with 99m-Tc-HMPAO brain single-photon emission tomography revealed diffuse hypoperfusion in the left cerebral hemisphere with decreased vascular reserve. After cranioplasty, multiple cerebral hemorrhages were observed on immediate postoperative computed tomography. Cerebral hemorrhage eventually improved without surgery. Here, we report a case with findings revealed through perfusion studies before and after surgery.
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KEYWORD
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Decompressive craniectomy, Reperfusion injury, Traumatic intracranial hemorrhage, Technetium Tc 99m exametazime
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