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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(04): 837-841
DOI: 10.1055/s-0045-1809919
Case Report

Ultrasound-Guided Scalp Block for Chronic Subdural Hematoma Evacuation—A Case Series and Review of Literature

Authors

  • Ashwini Reddy 

    1   Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Kajal Jain

    1   Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Amiya Kumar Barik 

    1   Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Kirandeep Kaur

    1   Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract

Burr hole craniotomy for the evacuation of subdural hematoma (SDH) can be performed under general anesthesia, surgical site local anesthesia, or scalp block. The prevalence of SDH is higher in the geriatric age group who often suffers from multiple comorbidities. The use of general anesthesia with polypharmacy and airway manipulation may adversely affect the systemic physiology in these patients with substantially decreased reserve. Relief of pain is often inadequate with surgical site local anesthesia leading to tachycardia, hypertension, adverse cardiovascular events, and poor patient satisfaction. Scalp block provides dense prolonged blockade of select target nerves and avoids sedation facilitating early recovery and discharge. However, it is associated with multiple complications including intraneural/arterial injection, and local anesthetic systemic toxicity. The use of ultrasound has ushered in a new era in the field of regional anesthesia; however, the use of ultrasound-guided scalp blocks is not routinely practiced. The use of ultrasound has an opioid-sparing effect and avoids complications like facial nerve palsy and hematoma. We report the first case series of successful ultrasound-guided scalp blocks for the evacuation of chronic SDH.

Keywords

burr hole - geriatric patients - ultrasound - scalp block - subdural hematoma

Authors' Contributions

A.R. helped in the collection of data, literature review, and manuscript preparation. K.J. helped in the literature review, manuscript preparation, editing, and review. A.K.B. was involved in the literature review, manuscript preparation, editing, and review. K.K. helped in manuscript preparation, editing, and review. The manuscript has been read and approved by all the authors, the requirements for authorship as stated earlier in this document have been met, and each author believes that the manuscript represents honest work if that information is not provided in another form.


Patients' Consent

Informed consent was obtained from all the participants of the study.




Publication History

Article published online:
26 June 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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