Endoscopic Surgery for Traumatic Acute Subdural Hematoma
| Autor: | Atsushi Saito, Mizuho Inoue, Hiroyuki Kon, Hiroki Uchida, Tatsuya Sasaki, Michiharu Nishijima |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Acute subdural hematoma business.industry medicine.medical_treatment Glasgow Coma Scale medicine.disease Endoscopic surgery Trauma lcsh:RC346-429 Head trauma Shunt (medical) Surgery Published online: January 2014 Hematoma medicine.anatomical_structure Normal pressure hydrocephalus medicine Forehead Local anesthesia Neurology (clinical) Radiology business Craniotomy lcsh:Neurology. Diseases of the nervous system |
| Zdroj: | Case Reports in Neurology Case Reports in Neurology, Vol 5, Iss 3, Pp 208-213 (2014) |
| ISSN: | 1662-680X |
| Popis: | Traumatic acute subdural hematoma (ASDH) is generally addressed by craniotomy under general anesthesia. We report a patient whose traumatic ASDH was treated under local anesthesia by one-burr-hole endoscopic surgery. This 87-year-old woman had undergone coil embolization for a ruptured right middle-cerebral artery aneurysm and placement of a ventriculoperitoneal shunt for normal pressure hydrocephalus 5 years earlier. Upon admission, she manifested consciousness disturbance after suffering head trauma and right hemiplegia. Her Glasgow Coma Scale score was 8 (E2V2M4). Computed tomography (CT) demonstrated a thick, left-frontotemporal ASDH. Due to her advanced age and poor condition, we performed endoscopic surgery rather than craniotomy to evacuate the ASDH. Under local anesthesia, we made a burr hole in her left forehead and increased its size to 15 mm in diameter. After introducing a transparent sheath into the hematoma cavity with a rigid endoscope, the clot was evacuated with a suction tube. The arterial bleeding point was electrically coagulated. A postoperative CT scan confirmed the reduction of the hematoma. There was neither brain compression nor brain swelling. Her consciousness disturbance and right hemiplegia improved immediately. Endoscopic surgery may represent a viable method to address traumatic intracranial hematomas in some patients. |
| Databáze: | OpenAIRE |
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