Citation

Bin W, Tianmin Y. Childs Nerv. Syst. 2020; ePub(ePub): ePub.

Affiliation

Department of Neurosurgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Hexi Street 71, Nanjing, 210019, China.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00381-020-04555-0

PMID

32166343

Abstract

We have read with great interest the article “Acute cerebellar edema after traumatic brain injury in a child. a case report” written by Dr. Nader Hejrati and his colleagues [1]. This article has been translated into Chinese and published on the website “Neurosurgery News,” which has attracted the attention of many neurosurgeons in China and prompted plenty of discussion.

In this article, an unusual case of acute cerebellar swelling after TBI with supratentorial contusions in a 10-year-old boy is described. In addition, the authors discussed the possible pathophysiological mechanism of this phenomenon. Some factors, such as posttraumatic sinus venous thrombosis, hypoosmolar hyponatremia, and disturbance of venous drainage, are proved unlikely in the case. Fortunately, with suboccipital decompressive and external ventricular drain surgery, bifrontal craniectomy, and ventriculoperitoneal shunt, the boy recovered with no evident neurological findings.

Nevertheless, we think that the immediate deterioration of the boy was due to the central hernia and tonsillar hernia caused by bifrontal contusion and edema. Supratentorial brain contusion with brain edema led to the increase in intracranial pressure, the downward displacement of the cerebral hemispheres, and the compression of venous sinuses at the base of the skull, which resulted in the disturbance ...

Language: en