Subscribe to RSS
DOI: 10.1055/s-0035-1554949
Emergent Burr Hole Drainage of Traumatic Acute Subdural Hematoma with Drain Placement in Preexisting Coagulopathy Showing Rapid Neurological Deterioration: A Novel Technique
Subject Editor:
Publication History
16 June 2014
02 December 2014
Publication Date:
30 June 2015 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00029202/201501/lookinside/thumbnails/10-1055-s-0035-1554949_00117oa-1.jpg)
Abstract
Aim The aim of this article is to investigate the efficacy of emergency burr hole drainage of significantly thicker acute subdural hematoma (ASDH) with coagulopathy.
Patient and Methods A 23-year-old man presented with ASDH of left fronto-temporo-parietal region due to trauma following trivial injury. Patient was chronic alcoholic having coagulopathy and thrombocytopenia. He had rapid deterioration in neurological status. Though craniotomy and hematoma evacuation was planned initially, in view of persistent coagulopathy, emergent burr hole evacuation was performed. Neurological symptoms improved dramatically after the burr hole evacuation. He became alert and could walk unassisted 3 days after surgery, although psychic disturbance resulting from cerebral contusion persisted.
Result Burr hole evacuation is an useful treatment for significant thicker ASDH with coagulopathy, as procedure can be performed easily and rapidly, aids in achieving reduction of intracranial pressure while purchasing time for correction of coagulopathy.
Conclusion Emergency burr hole drainage should be considered in rapidly deteriorating patients with significant thicker ASDH with persistent thrombocytopenia and coagulopathy showing rapid neurological deterioration.
-
References
- 1 Ballock R, Hanneman CO, Murray L, Teasdale GM. Recurrent hematomas following craniotomy for traumatic intracranial mass. J Neurosurg 1990; 72: 9-14
- 2 Stem SC, Young GS, Talluci R , et al Delayed brain injury after head trauma: significance of coagulopathy. Neurosurgery 1992; 30: 160-165
- 3 Koc RK, Akdemir H, Oktem IS, Meral M, Menku A. Acute subdural hematoma: outcome and outcome prediction. Neurosurg Rev 1997; 20: 239-244
- 4 Motohashi O. Single burr hole evacuation of traumatic ASDH of posterior fossa in emergency room. J Neurotrauma 2002; 19: 993-998
- 5 Yanagawa Youichi, Sakamoto Toshihisa. Results of single burr hole drainage for acute subdural hematoma with non-reactive pupil. Turk Neurosurg 2012; 22: 196-199