new hematoma
Complications of evacuation of cranial epidural hematoma include re-accumulation of clot and formation of a new hematoma.
Many of the complications of craniotomy for evacuation of epidural hematoma are common to all craniotomies:
Table: Neurosurgical Risks & Complications
Pins are screwed into the outer table through the skin and scalp. The anterior pins are frequently placed close to the course of the superficial temporal artery.
Immediate post operative:
Bleeding from pin sites
Patient -- anatomy:
Bleeding from a pin site usually results from placement of the pin through a scalp artery (most commonly the SUPERFICIAL TEMPORAL artery). The pulse of the main trunk of the artery can usually be felt and if felt the pin can be placed so as to avoid it, but a smaller non-palpable branch may be inadvertently penetrated by a skull-fixation pin.
No consequence: There is no physiologic or cosmetic significance to injury to a small scalp artery by a skull fixation pin
Band-Aids are placed over the pin sites. If bleeding continues after the Band-Aids are placed, it may be necessary to place a non-absorbable (requires removal 5-10 days later at follow-up clinic visit) suture.
bleeding from pin sites less than 5% (virtually none after 24 hours)
Planning
Technique:
Bleeding from pin sites can be prevented by placing the pins as far from the likely course of the superficial temporal and occipital arteries as soon as possible.
A new hematoma in a different locatiion can occur following
Patient -- anatomy:
Bleeding from a pin site usually results from placement of the pin through a scalp artery (most commonly the SUPERFICIAL TEMPORAL artery). The pulse of the main trunk of the artery can usually be felt and if felt the pin can be placed so as to avoid it, but a smaller non-palpable branch may be inadvertently penetrated by a skull-fixation pin.
No consequence: There is no physiologic or cosmetic significance to injury to a small scalp artery by a skull fixation pin
Band-Aids are placed over the pin sites. If bleeding continues after the Band-Aids are placed, it may be necessary to place a non-absorbable (requires removal 5-10 days later at follow-up clinic visit) suture.
bleeding from pin sites less than 5% (virtually none after 24 hours)
Planning
Technique:
Bleeding from pin sites can be prevented by placing the pins as far from the likely course of the superficial temporal and occipital arteries as soon as possible.