Postoperative intracerebral and intraventricular hemorrhages following removal of a chronic subdural hematoma

We report a patient with multiple intracerebral and intraventricular hemorrhages after removal of bilateral chronic subdural hematomas (CSDH). Possible mechanisms include a sudden increase in cerebral blood flow within fragile cerebral vessels following decompression of CSDH, defective vascular autoregulation, and damage to the cerebral vascular tree. Clinical awareness of this complication and slow decompression of CSDH are stressed. © 2009 Elsevier Ltd. All rights reserved.