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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El desarrollo de un hematoma extradural contra-lateral durante la evacuaci&#243;n de un hematoma extraaxial de origen traum&#225;tico es un hecho muy infrecuente&#46; Generalmente se produce en pacientes con traumatismo craneoencef&#225;lico &#40;TCE&#41; grave en el que se aprecia un hematoma extraaxial y una fractura craneal contralateral&#46; El r&#225;pido aumento de la tensi&#243;n cerebral en el &#225;rea operada tras la evacuaci&#243;n del hematoma inicial debe hacer sospechar el diagn&#243;stico&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un paciente con un TCE grave y un hematoma extradural durante cuya evacuaci&#243;n se produjo el desarrollo de un hematoma extradural contralateral&#46; Su existencia fue sospechada debido al repentino aumento de la tensi&#243;n cerebral durante la evacuaci&#243;n del primer hematoma y diagnosticado tras realizaci&#243;n de tomograf&#237;a computarizada craneal &#40;TC&#41; de emergencia&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La disminuci&#243;n de la presi&#243;n intracraneal y la p&#233;rdida del efecto tamp&#243;n tras la evacuaci&#243;n del hematoma inicial&#44; se consideran los mecanismos patog&#233;nicos fundamentales en el desarrollo del hematoma contralateral&#46;</p>"
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        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The development of an extradural hematoma during the evacuation of a traumatic extracerebral hematoma is a very rare event&#46; It occurs in patients with a severe head injury that present with both an extraaxial hematoma and a contralateral skull fracture&#46; Recognition of the signiflcance of a sudden increase in the cerebral tension after hematoma evacuation is the key for a pront diagnosis of the development of a contralateral lesion&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We present the case of a patient with a severe head trauma and an extradural hematoma who developed a contralateral extradural hematoma during evacuation of the initial one&#46; The development of a contralateral lesion was suspected by a sudden and unexpected increase in cerebral tension during evacuation of the flrst hematoma and conflrmed by emergency CT sean&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We think that the most important pathogene-tic mechanisms involved in the development of a contralateral extradural hematoma are the rapid fall of intracranial pressure&#44; the loss of tamponade effect achieved by the energetic use of antiedema measures and the evacuation of the ipsilateral hematoma&#46;</p>"
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Desarrollo intraoperatorio de un hematoma extradural contralateral a otro previo
Contralateral extradural hematoma during evacuation of a previous one
M. Ortega-Martínez
, I. Fernández-Portales, L.F. Gómez Perals, J.M. Cabezudo
Servicio de Neurocirugía. Hospital Regional Universitario Infanta Cristina. Badajoz

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