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Ann Thorac Surg 1975;19:269-276
© 1975 The Society of Thoracic Surgeons

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Articles

Subdural Hematoma Following Open-Heart Operations

Departments of Pathology and Cardiology, Children's Orthopedic Hospital and Medical Center, Seattle, Wash

Accepted for publication July 29, 1974.

^* Address reprint requests to Dr. Tenckhoff, Children's Orthopedic Hospital and Medical Center, 4800 Sand Point Way N.E., Seattle, Wash. 98105

Six patients who died following open-heart operations were found at postmortem examination to have acute subdural hematomas. On the basis of the clinical and postmortem findings, two factors in the pathogenesis of the hemorrhage are postulated. In the presence of intraoperative heparin administration, significant hematoma formation may result from damage to the bridging dural veins from minor, inadvertent head trauma or alterations in cerebral volume from fluid shifts. Manipulation of the head in patients who have been given heparin should be undertaken with extreme care, particularly in infants. In any patient with neurological dysfunction who has also had an open-heart operation, the possibility of an expanding subdural hematoma must be considered.

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