• Hao-Kuang Wang, Kang Lu, Cheng-Loong Liang, Yu-Duan Tsai, Kuo-Wei Wang, and Po-Chou Liliang.
• Department of Neurosurgery, E-Da Hospital, I-Shou University, I-Shou University, 1 Yi-Da Road, Yan-Chau Shiang, Kaohsiung County, 824, Taiwan.
• Injury. 2012 May 1;43(5):594-7.

BackgroundContralateral subdural effusion caused by decompressive craniectomy (DC) is not uncommon. However, it has rarely been reported.MethodFrom 2004 to 2008, 123 severe traumatic brain injury (TBI) patients were identified as having undergone DC for increased intracranial pressure (IICP) with or without removal of a blood clot or contused brain. Of these 123 patients, nine developed delayed contralateral subdural effusion. Demographics, clinical presentations, treatment and outcome were reported.ResultsThe overall incidence of contralateral subdural effusion was 7.3%. On average, this complication was found 23 days after DC. Of the nine patients, six had neurological deterioration and received drainage through a burr hole. One patient needed a subsequent subduro-peritoneal shunting because of recurrent subdural effusion.ConclusionContralateral subdural effusions may be not uncommon and need more aggressive treatment because of their tendency to cause midline shift. Surgical intervention may be warranted if the patients develop deteriorating clinical manifestations or if the subdural effusion has an apparent mass effect.Copyright © 2010. Published by Elsevier Ltd.

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