Objective

Contralateral subdural effusion after decompressive craniectomy (CSEDC) is rare, and the optimal treatment is not determined. We present 11 cases of CSEDC and give an overview of the English literature pertaining to this disease.

Methods

We searched the database at our institution and performed a search of English literature in PubMed and Google Scholar. Keywords used were as follows (single word or combination): “subdural hygroma”; “subdural effusion”; “decompressive craniectomy”. Only patients with CSEDC and contained adequate clinical information pertinent to the analysis were included.

Results

11 cases of CSEDC were recorded at our institution. They comprised ten men and one woman with an average age of 41.9 years. All the 8 symptomatic patients underwent surgery and the CSEDC resolved gradually. 68 cases of CSEDC were found in the literature. Including ours, a total of 79 patients were analyzed. Conservative treatment was effective in the asymptomatic patients. 41.7% of the symptomatic CSEDC underwent burr hole drainage and successfully drained the CSEDC. However, 76% of them received subsequent surgery to manage the reaccumulation of CSEDC. 25% of the symptomatic patients underwent cranioplasty, while 13.3% of them received Ommaya drainage later because of CSEDC recurrence. 18.3% of the symptomatic patients underwent cranioplasty plus subduroperitoneal shunting, and all CSEDC resolved completely.

Conclusions

Burr hole drainage appears to be only a temporary measure. Early cranioplasty should be performed for patients with CSEDC. CSF shunting procedures may be required for patients in whom CSEDC have not been solved or hydrocephalus manifest after cranioplasty.

中文翻译：

---

去骨瓣减压术后对侧硬膜下积液：最佳治疗方法是什么？

客观的

去骨瓣减压术（CSEDC）后对侧硬膜下积液很少见，最佳治疗方案尚未确定。我们介绍了 11 例 CSEDC 病例，并概述了与这种疾病有关的英文文献。

方法

我们搜索了我们机构的数据库，并在 PubMed 和 Google Scholar 中搜索了英语文献。使用的关键词如下（单个或组合）：“硬膜下水瘤”；“硬膜下积液”；“去骨瓣减压术”。仅纳入 CSEDC 患者并包含与分析相关的足够临床信息。

结果

我院记录了11例CSEDC病例。他们包括十名男性和一名女性，平均年龄为 41.9 岁。8例有症状的患者均接受了手术治疗，CSEDC逐渐消退。文献中发现CSEDC 68例。包括我们在内，共分析了 79 名患者。保守治疗对无症状患者有效。41.7% 有症状的 CSEDC 接受了钻孔引流并成功引流了 CSEDC。然而，他们中的 76% 接受了后续手术以管理 CSEDC 的重新积累。25% 有症状的患者接受了颅骨成形术，而其中 13.3% 的患者后来因为 CSEDC 复发接受了 Ommaya 引流。18.3% 的有症状患者接受了颅骨成形术加硬膜下腹膜下分流术，所有 CSEDC 完全消退。

结论

钻孔排水似乎只是一种临时措施。CSEDC 患者应进行早期颅骨成形术。对于 CSEDC 尚未解决或颅骨成形术后出现脑积水的患者，可能需要进行 CSF 分流手术。