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The Annals of Thoracic Surgery, Vol 19, 269-276, Copyright © 1975 by The Society of Thoracic Surgeons
HF Krous, L Tenckhoff, NS Gould and SJ Stamm
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.
ARTICLES
Subdural hematoma following open-heart operations
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