6533b7d1fe1ef96bd125d8e2

RESEARCH PRODUCT

Epidural hematoma after cochlear implantation in a 2.5-year-old boy.

Jan GosepathWolf J. MannJan Maurer

subject

Hematoma Epidural CranialMaleReoperationmedicine.medical_specialtyCritical CareInfarctionBilateral DeafnessAudiologyDeafnessDiagnosis DifferentialInfarction Posterior Cerebral ArteryEpidural hematomaPostoperative ComplicationsMidline shiftmedicine.arteryAnterior cerebral arterymedicineElectrocoagulationHumansDominance CerebralNeurologic Examinationbusiness.industryInfarction Middle Cerebral Arterymedicine.diseaseCochlear ImplantationMagnetic Resonance ImagingMeningeal ArteriesSensory SystemsTentoriumTemporal LobeSurgeryEpistaxisOtorhinolaryngologyIntracranial EmbolismChild PreschoolNeurology (clinical)ImplantOccipital LobeComplicationbusinessTomography X-Ray ComputedFollow-Up Studies

description

OBJECTIVE Report a case of an epidural hematoma after cochlear implantation in a 2.5-year-old boy, the diagnostic and therapeutical emergency management, as well as the postinterventional course and rehabilitation of the child. STUDY DESIGN Retrospective case review. PATIENT Two and a half-year-old boy, suffering from early onset, profound sensorineural hearing loss had been diagnosed at an age of 1.5 years, which had been more severe on the right side initially, but had progressed to bilateral deafness. INTERVENTION AND COMPLICATION: Cochlear implantation on the left side, followed up by an extensive epidural hematoma, causing intracranial compression with a midline shift of 15 mm to the right side. This initial complication was followed up by arterial infarction not only of the middle but also the posterior as well as the anterior cerebral artery, most likely caused by incarceration through the tentorium. RESULTS After immediate neurosurgical intervention and intensive care treatment including low-dose anticoagulation and high doses of corticosteroids, the child recuperated completely within 3 weeks without any remaining neurologic deficits. CONCLUSION In cochlear implantation, especially if placement of the implant housing is associated with considerable bone work, epidural hematoma has to be considered as an extremely rare, but life-threatening, complication.

10.1097/00129492-200503000-00012https://pubmed.ncbi.nlm.nih.gov/15793405