- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
Correspondence Address:
Satya Bhusan Senapati
Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
DOI:10.4103/2152-7806.97540
Copyright: © 2012 Mishra SS. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.How to cite this article: Mishra SS, Senapati SB, Parida DK. Venous infarction following surgery for chronic subdural hematoma: A lesson for us. Surg Neurol Int 19-Jun-2012;3:69
How to cite this URL: Mishra SS, Senapati SB, Parida DK. Venous infarction following surgery for chronic subdural hematoma: A lesson for us. Surg Neurol Int 19-Jun-2012;3:69. Available from: http://sni.wpengine.com/surgicalint_articles/venous-infarction-following-surgery-for-chronic-subdural-hematoma-a-lesson-for-us/
Dear Sir,
A 30-year-old male presented after 2 months of head injury with complaints of disorientation and poor feeding for last 4 days. He was initially treated at a local hospital. Computed tomography (CT) scan was done for the above complaint (after 55 days of head injury) in a private local diagnostic center, which was reported by a radiologist as lt hemispheric chronic subdural hematoma with mass effect. He was referred to our hospital as neurosurgery facility was not available there. On initial evaluation, he was responding to verbal commands but was not fully oriented to time, place, and person. He did not have any focal motor or sensory deficit. His pupils were bilaterally equal and reacting well to light. Neurological examination of his cranial nerves showed it to be within normal limits. We admitted the case after evaluating the patient and seeing the CT scan plate with report. He was planned for burr hole and evacuation under general anesthesia (GA). Burr hole was done over lt posterior parietal area, and dura was cauterized in a cruciate manner and nicked in the center. Profuse fresh bleeding occurred as dura was nicked. Suction over cotton piece reveled that brain matter was tightly attached to dura, with bleeding from a cortical vein, which was controlled by cauterizing the bleeding vein. When we rechecked the CT scan plate, to our surprise, we found that we had done a mistake by operating on the lt side whereas the lesion was on the rt side. Although chronic subdural hematoma was on the lt side of CT scan, the technician had marked that side as “r” [
On the 2nd postoperative day, we did check scan. Underlying the first burr hole, there was an area of hypodensity suggesting associated venous infarct [
The case of wrong side being operated is a nightmare for surgeons. Such incidents happen so frequently that it is a significant risk for many surgeons during their professional career. Such types of cases are always underreported, the reason being obvious. Wrong-site surgery results from misinformation or misperception of the patient's orientation.[
References
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