Traumatic Intracerebral Hemorrhage after Reduction Malarplasty

Myeong Jin Kim; Myoung Soo Kim; Chae Heuck Lee

doi:10.13004/kjnt.2013.9.1.23

Journal List > Korean J Neurotrauma > v.9(1) > 1058923

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Kim, Kim, and Lee: Traumatic Intracerebral Hemorrhage after Reduction Malarplasty

Case Report

Korean J Nutr 2013;9(1):23-26.

Published online: 20 April 2013

DOI: https://doi.org/10.13004/kjnt.2013.9.1.23

Traumatic Intracerebral Hemorrhage after Reduction Malarplasty

Myeong Jin Kim, MD¹, Myoung Soo Kim, MD^1,, Chae Heuck Lee, MD²

¹Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

²Department of Neurosurgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

Address for correspondence: Myoung Soo Kim, MD Department of Neurosurgery, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 100-032, Korea Tel: +82-2-2270-0032, Fax: +82-2-2270-0573 E-mail: hanibalkms@hanmail.net

Received 2 October 2012 Revised 7 January 2013 Accepted 8 January 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reduction malarplasty (RMP) to reshape the facial contour is one of the most popular aesthetic surgical procedures in Asia. Here we report a case of intracerebral hematoma (ICH) after RMP. A 31-year-old woman was referred to our hospital following RMP. On arrival at our emergency room, she presented with deep drowsy mentality and right hemiparesis. Computed tomographic scan demonstrated an ICH. We conducted stereotactic aspiration of the blood clots. Because of increased ICH after the operation, the patient underwent craniotomy and hematoma evacuation. After removal of hematoma, intraoperatively a defect of the middle cranial fossa dura, a skull base bony defect, and a bony fragment were noticed. We think that these lesions have been caused by aggressive manipulation of surgical instruments. To our knowledge, ICH after RMP was not reported. The radiologic features of this case and suggested mechanism of the complication are described.

Keywords: Reduction, Malar, Complication, Cerebral hemorrhage

References

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FIGURE 1.

Brain noncontrast computed tomographic scan performed at the emergency room shows intracerebral hematoma located in the left temporal lobe.

FIGURE 2.

Skull AP (A) and lateral X-ray (B) images demonstrate the postoperative state of reduction malarplasty. AP: antero-posterior.

FIGURE 3.

Brain noncontrast computed tomographic scan performed after 1st operation demonstrates intracerebral hematoma located in the left temporal lobe.

FIGURE 4.

Intraoperative finding of craniotomy and hematoma evacuation shows the dural defect (black arrow) located in the left middle cranial fossa and a bony fragment (white arrow).

FIGURE 5.

Brain noncontrast computed tomographic scan performed after 2nd operation demonstrates almost complete removal of the intracerebral hematoma.

FIGURE 6.

Brain computed tomography-angiogram (A) demonstrates bony abnormalities (arrows) of the left middle cranial fossa. Coronal computed tomographic scan with bone window setting (B) shows bony fragment in intracranial cavity (white arrow) and air bubbles in muscle layer (black arrow).

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