inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2024-9-1-129-135inovmed-822Research ArticleОБЗОРЫREVIEWSСубдуральные гигромы после декомпрессионных краниотомийSubdural hygromas After Decompressive Craniotomieshttps://orcid.org/0000-0001-6321-4557ШнякинП. Г.ShnyakinP. G.

Шнякин Павел Геннадьевич, д. м. н., заведующий кафедрой травматологии, ортопедии и нейрохирургии

Красноярск

Pavel G. Shnyakin, Dr Sci. (Med.), Head of the Department of Traumatology, Orthopedics and Neurosurgery

Krasnoyarsk

https://orcid.org/0000-0001-6393-0430БотовА. В.BotovA. V.

Ботов Антон Витальевич, к. м. н., доцент кафедры травматологии, ортопедии и нейрохирургии

Красноярск

Anton V. Botov, Cand. Sci. (Med.), Associate Professor at the Department of Traumatology, Orthopedics and Neurosurgery

Krasnoyarsk

https://orcid.org/0000-0001-9390-3134РуденкоП. Г.RudenkoP. G.

Руденко Павел Геннадьевич, к. м. н., ассистент кафедры травматологии, ортопедии и нейрохирургии

Красноярск

Pavel G. Rudenko, Cand. Sci. (Med.), Assistant Professor at the Department of Traumatology, Orthopedics and Neurosurgery

Krasnoyarsk

https://orcid.org/0000-0002-7099-4384ЛосеваА. С.LosevaA. S.

Лосева Анастасия Сергеевна, клинический ординатор кафедры травматологии, ортопедии и нейрохирургии

660022, Красноярск, ул. Партизана Железняка, д. 1

Anastasia S. Loseva, Resident, Department of Traumatology, Orthopedics and Neurosurgery

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, ulitsa Partizana Zheleznyaka 1, Krasnoyarsk, 660022

Anastasia.loseva13@gmail.comКрасноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого; Краевая клиническая больницаРоссияProfessor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Regional Clinical HospitalRussian FederationКрасноярский государственный медицинский университет им. проф. В.Ф. Войно-ЯсенецкогоРоссияProfessor V.F. Voino-Yasenetsky Krasnoyarsk State Medical UniversityRussian Federation20243003202401129135Copyright © Шнякин П.Г., Ботов А.В., Руденко П.Г., Лосева А.С., 20242024Шнякин П.Г., Ботов А.В., Руденко П.Г., Лосева А.С.Shnyakin P.G., Botov A.V., Rudenko P.G., Loseva A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/822

Субдуральные гигромы (СГ) встречаются после различных операций на головном мозге, часто бывают асимптомными, но иногда требуют хирургического лечения. СГ могут развиваться в ближайшем послеоперационном периоде, но чаще через несколько недель, а иногда и месяцев после операции. Наиболее часто субдуральные гигромы развиваются после декомпрессионных трепанаций черепа у пациентов с черепно-мозговой травмой или массивным инсультом. Патогенез определяется тем, что на фоне большого костного дефекта возникает разница давления в черепе и при сопутствующем смещении желудочковой системы нарушается нормальная циркуляция цереброспинальной жидкости, что способствует перераспределению ликворотока в субдуральное пространство.

В обзоре представлены данные современных исследований по СГ после декомпрессионных трепанаций черепа, факторам риска их развития и тактике ведения пациентов. Также представлен собственный клинический случай рецидивной субдуральной гигромы у пациента, прооперированного по поводу разрыва аневризмы средней мозговой артерии.

Subdural hygromas occur after various brain interventions, are often asymptomatic but sometimes may require surgical treatment. They can develop in the immediate postoperative period, but they are more common a few weeks or even months after surgery. Subdural hygromas are particularly common after decompressive craniotomy in patients with traumatic brain injury or massive stroke. The pathogenesis is explained by the fact that a large bone defect causes a pressure difference in the skull, and a concomitant displacement of the ventricular system disrupts the normal cerebrospinal fluid circulation, contributing to the redistribution of cerebrospinal fluid flow into the subdural space.

We review data from contemporary studies on subdural hygromas after decompressive craniotomy, their risk factors, and management strategies. We also present our case of recurrent subdural hygroma in a patient operated on for a ruptured aneurysm of the middle cerebral artery. 

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The authors declare that there are no conflicts of interest present.