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

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