Chronic subdural hematomas mainly occur amongst elderly people and usually develop after
minor head injuries. In younger patients, subdural collections may be related to
hypertension, coagulopathies, vascular abnormalities, and
substance abuse. Different techniques can be used for the surgical treatment of symptomatic
chronic subdural hematomas : single or double burr-hole evacuation, with or without subdural drainage, twist-drill craniostomies and classical
craniotomies. Failure of the brain to re-expand,
pneumocephalus, incomplete evacuation, and recurrence of the fluid collection are common complications following these procedures.
Acute subdural hematomas may also occur. Rarely reported hemorrhagic complications include subarachnoid, intracerebral, intraventricular, and remote cerebellar
hemorrhages. The causes of such uncommon complications are difficult to explain and remain poorly understood. Overdrainage and
intracranial hypotension, rapid brain
decompression and shift of the intracranial contents, cerebrospinal fluid loss, vascular dysregulation and impairment of venous outflow are the main mechanisms discussed in the literature. In this article we report three cases of different post-operative intracranial
bleeding and review the related literature.