{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:22:04Z","timestamp":1763018524878,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key Research and Development Plan of China","award":["2019YFC0118503"],"award-info":[{"award-number":["2019YFC0118503"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Although chronic subdural hematoma (CSDH) has been known for over several hundred years, the etiology and pathogenesis of it are still not completely understood. Neurosurgical procedures resulting in CSDH are a rare clinical complication, and there was no report about how subdural effusion (SDE) evolves into CSDH after deep brain stimulation (DBS) surgery. The formation mechanism of CSDH after surgery, especially in DBS surgery, and the effect of recovery, need to be explored. Methods: We present two cases, complicated with SDE after DBS surgery, serious dysfunction complications such as hemiplegia and aphasia occurred on the postoperative day 36 and 49 individually, and images showed CSDH. Fusion image showed the bilateral electrodes were significantly shifted. Then, they were performed to drill craniotomy with a closed system drainage. Result: The symptoms of hemiplegia and aphasia caused by CSDH were completely recovered, and the follow-up images showed CSDH was disappeared. However, DBS stimulation is poorly effective, it cannot reach the preoperative level, especially in the ipsilateral side of CSDH. Conclusions: The iatrogenic SDE that evolved into CSDH in the present two cases shows that SDE is one of the causes of CSDH. Patients develop SDE after DBS, which increases the risk of developing CSDH. CSDH after DBS can be successfully treated. however, the postoperative efficacy of DBS will decline.<\/jats:p>","DOI":"10.3390\/brainsci12101375","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T21:07:11Z","timestamp":1665436031000},"page":"1375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Subdural Effusion Evolves into Chronic Subdural Hematoma after Deep Brain Stimulation Surgery: Case Report and Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"given":"Dongdong","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The First Medical Clinical Center, PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanyuan","family":"Dang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Clinical Center, PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Clinical Center, PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiqiang","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Medical Clinical Center, PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"ref_1","first-page":"11","article-title":"Chronic Subdural Hematoma","volume":"3","author":"German","year":"1930","journal-title":"Yale J. Biol. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1001\/archsurg.1925.01120150002001","article-title":"Chronic subdural hematoma: Its pathology, its relation to pachymeningitis hemorrhagica and its surgical treatment","volume":"11","author":"Putnam","year":"1925","journal-title":"Arch. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/j.mehy.2007.11.014","article-title":"Traumatic subdural effusion evolves into chronic subdural hematoma: Two stages of the same inflammatory reaction?","volume":"70","author":"Feng","year":"2008","journal-title":"Med. Hypotheses"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s007010050077","article-title":"Serum protein exudation in chronic subdural haematomas: A mechanism for haematoma enlargement?","volume":"140","author":"Fujisawa","year":"1998","journal-title":"Acta Neurochir."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3171\/jns.1976.45.1.0026","article-title":"Role of local hyperfibrinolysis in the etiology of chronic subdural hematoma","volume":"45","author":"Ito","year":"1976","journal-title":"J. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"512","DOI":"10.3171\/jns.1980.53.4.0512","article-title":"Oncotic pressure of subdural fluids","volume":"53","author":"Weir","year":"1980","journal-title":"J. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/0090-3019(88)90269-8","article-title":"Tissue-type plasminogen activator in the chronic subdural hematoma","volume":"30","author":"Ito","year":"1988","journal-title":"Surg. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1080\/02699050310001645801","article-title":"ReviewNatural history of chronic subdural haematoma","volume":"18","author":"Lee","year":"2004","journal-title":"Brain Inj."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s10143-004-0337-6","article-title":"Demographics and prevalent risk factors of chronic subdural haematoma: Results of a large single-center cohort study","volume":"27","author":"Baechli","year":"2004","journal-title":"Neurosurg. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/BF02352062","article-title":"Aspirin as a risk factor for hemorrhage in patients with head injuries","volume":"15","author":"Reymond","year":"1992","journal-title":"Neurosurg. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1001\/archneur.1982.00510140003001","article-title":"Subdural Hematoma and Oral Anticoagulant Therapy","volume":"39","author":"Wintzen","year":"1982","journal-title":"Arch. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1136\/jnnp.52.7.829","article-title":"Anticoagulation-related intracranial extracerebral haemorrhage","volume":"52","author":"Mattle","year":"1989","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"897","DOI":"10.7326\/0003-4819-120-11-199406010-00001","article-title":"Risk factors for intracranial hemorrhage in outpatients taking warfarin","volume":"120","author":"Hylek","year":"1994","journal-title":"Ann. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"295","DOI":"10.3171\/2008.10.JNS08428","article-title":"Spontaneous spinal cerebrospinal fluid leaks as the cause of subdural hematomas in elderly patients on anticoagulation","volume":"112","author":"Schievink","year":"2010","journal-title":"J. Neurosurg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"310","DOI":"10.3171\/2015.1.JNS14309","article-title":"Postoperative subdural hygroma and chronic subdural hematoma after unruptured aneurysm surgery: Age, sex, and aneurysm location as independent risk factors","volume":"124","author":"Park","year":"2016","journal-title":"J. Neurosurg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1136\/jnnp.50.12.1694","article-title":"Chronic subdural haematoma preceded by persistent traumatic subdural fluid collection","volume":"50","author":"Ohno","year":"1987","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/BF01808545","article-title":"Spontaneous evolution of posttraumatic subdural hygroma into chronic subdural haematoma","volume":"127","author":"Park","year":"1994","journal-title":"Acta Neurochir."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3346\/jkms.1996.11.1.55","article-title":"Relations among traumatic subdural lesions","volume":"11","author":"Lee","year":"1996","journal-title":"J. Korean Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"551","DOI":"10.3109\/02688699409002947","article-title":"The pathogenesis and fate of traumatic subdural hygroma","volume":"8","author":"Lee","year":"1994","journal-title":"Br. J. Neurosurg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1007\/s00701-019-03929-x","article-title":"Early detection of cerebral ischemic events on intraoperative magnetic resonance imaging during surgical procedures for deep brain stimulation","volume":"161","author":"Cui","year":"2019","journal-title":"Acta Neurochir."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3171\/2015.1.JNS141534","article-title":"Intraoperative MRI for optimizing electrode placement for deep brain stimulation of the subthalamic nucleus in Parkinson disease","volume":"124","author":"Cui","year":"2016","journal-title":"J. Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015 statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst. Rev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"122","DOI":"10.3171\/2015.11.JNS151341","article-title":"Intraoperative electrocorticography for physiological research in movement disorders: Principles and experience in 200 cases","volume":"126","author":"Panov","year":"2017","journal-title":"J. Neurosurg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3171\/2015.6.JNS15716","article-title":"Bilateral deep brain stimulation of the fornix for Alzheimer\u2019s disease: Surgical safety in the ADvance trial","volume":"125","author":"Ponce","year":"2016","journal-title":"J. Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"749","DOI":"10.2176\/nmc.51.749","article-title":"Complications of subthalamic nucleus stimulation in Parkinson\u2019s disease","volume":"51","author":"Umemura","year":"2011","journal-title":"Neurol. Med. Chir."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1136\/jnnp.2005.081232","article-title":"Deep-brain stimulation: Long-term analysis of complications caused by hardware and surgery--experiences from a single centre","volume":"77","author":"Voges","year":"2006","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1007\/s00701-011-0997-2","article-title":"Analysis of hemorrhagic risk factors during deep brain stimulation surgery for movement disorders: Comparison of the circumferential paired and multiple electrode insertion methods","volume":"153","author":"Park","year":"2011","journal-title":"Acta Neurochir."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"888","DOI":"10.3171\/jns.2005.102.5.0888","article-title":"Incidence of hemorrhage associated with electrophysiological studies performed using macroelectrodes and microelectrodes in functional neurosurgery","volume":"102","author":"Gorgulho","year":"2005","journal-title":"J. Neurosurg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1159\/000075156","article-title":"Hemorrhagic complications of microelectrode-guided deep brain stimulation","volume":"80","author":"Binder","year":"2003","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1227\/01.NEU.0000339173.77240.34","article-title":"Risk factors for hemorrhage during microelectrode-guided deep brain stimulation and the introduction of an improved microelectrode design","volume":"64","author":"Asaad","year":"2009","journal-title":"Neurosurgery"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1007\/s00701-003-0026-1","article-title":"Risk factors for the occurrence of chronic subdural haematomas after neurosurgical procedures","volume":"145","author":"Mori","year":"2003","journal-title":"Acta Neurochir."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"290","DOI":"10.3171\/JNS-07\/08\/0290","article-title":"The role of exudation in chronic subdural hematomas","volume":"107","author":"Tokmak","year":"2007","journal-title":"J. Neurosurg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"697","DOI":"10.2176\/nmc.38.697","article-title":"Quantitative Kinetic Analysis of Blood Vessels in the Outer Membranes of Chronic Subdural Hematomas","volume":"38","author":"Mori","year":"1998","journal-title":"Neurol. Med.-Chir."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1136\/jnnp.74.4.522","article-title":"High concentrations of procollagen propeptides in chronic subdural haematoma and effusion","volume":"74","author":"Sajanti","year":"2003","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/0090-3019(91)90177-B","article-title":"Immunohistochemical localization of tissue-type plasminogen activator in the lining wall of chronic subdural hematoma","volume":"35","author":"Fujisawa","year":"1991","journal-title":"Surg. Neurol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"560","DOI":"10.3346\/jkms.2000.15.5.560","article-title":"The fate of traumatic subdural hygroma in serial computed tomographic scans","volume":"15","author":"Lee","year":"2000","journal-title":"J. Korean Med. Sci."},{"key":"ref_37","first-page":"360","article-title":"Clinical characteristics of chronic subdural hematoma evolving from traumatic subdural effusion","volume":"40","author":"Liu","year":"2002","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1227\/00006123-199209000-00024","article-title":"Traumatic subdural hygroma: Pathology and meningeal enhancement on magnetic resonance imaging","volume":"31","author":"Hasegawa","year":"1992","journal-title":"Neurosurgery"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e7290","DOI":"10.1097\/MD.0000000000007290","article-title":"Effects of atorvastatin on chronic subdural hematoma: A systematic review","volume":"96","author":"Qiu","year":"2017","journal-title":"Medicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s00701-020-04588-z","article-title":"How to avoid pneumocephalus in deep brain stimulation surgery? Analysis of potential risk factors in a series of 100 consecutive patients","volume":"163","author":"Krauss","year":"2021","journal-title":"Acta Neurochir."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/10\/1375\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:49:27Z","timestamp":1760143767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/10\/1375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,10]]},"references-count":40,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["brainsci12101375"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12101375","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2022,10,10]]}}}