Preoperative trepanation and drainage for acute subdural hematoma: Two case reports

Lu,Tianshu; Guan,Jingyu; An,Chunli

doi:10.3892/etm.2015.2456

Preoperative trepanation and drainage for acute subdural hematoma: Two case reports

Authors:
- Tianshu Lu
- Jingyu Guan
- Chunli An
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Affiliations: Department of Pathogen Biology, School of Basic Medicine, China Medical University, Shenyang, Liaoning 110001, P.R. China, General Hospital of Shenyang Military Region, Shenyang, Liaoning 110001, P.R. China
Published online on: April 28, 2015 https://doi.org/10.3892/etm.2015.2456
Pages: 225-230

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Abstract

Craniotomy is frequently used for the treatment of acute subdural hematoma; however, it the procedure exhibits a high mortality rate. Preoperative trepanation and drainage in an emergency ward may reduce intracranial pressure, shorten operation time and lower patient mortality, and is thus applicable to the treatment of acute subdural hematoma. The present study reports the cases of two elderly patients that benefitted from trepanation and drainage of an acute subdural hematoma. In each case, the family members of the patients refused to consent to a craniotomy; thus, burr‑hole drainage was selected as an alternative option for relieving intracranial pressure. The risks require careful evaluation when considering whether trepanation with drainage is an option for a patient. Following treatment, the two cases were cured and discharged on days 48 and 18 after admission, respectively. The present case studies indicate that trepanation with drainage may be a promising approach for reducing craniotomy‑associated mortality and closely monitoring condition variation in elderly patients. Following trepanation with drainage, certain patients do not undergo a craniotomy.

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1	Park JY, Moon KS, Lee JK and Jeung KW: Rapid resolution of acute subdural hematoma in child with severe head injury: a case report. J Med Case Rep. 7:672013. View Article : Google Scholar : PubMed/NCBI
2	Chen SH, Chen Y, Fang WK, Huang DW, Huang KC and Tseng SH: Comparison of craniotomy and decompressive craniectomy in severely head-injured patients with acute subdural hematoma. J Trauma. 71:1632–1636. 2011. View Article : Google Scholar : PubMed/NCBI
3	Li LM, Kolias AG, Guilfoyle MR, Timofeev I, Corteen EA, Pickard JD, Menon DK, Kirkpatrick PJ and Hutchinson PJ: Outcome following evacuation of acute subdural haematomas: a comparison of craniotomy with decompressive craniectomy. Acta Neurochir (Wien). 154:1555–1561. 2012. View Article : Google Scholar : PubMed/NCBI
4	Paci GM, Sise MJ, Sise CB, Sack DI, Shackford SR, Kureshi SA, Osler TM, Yale RS, Riccoboni ST, Peck KA and O'Reilly EB: Preemptive craniectomy with craniotomy: what role in the management of severe traumatic brain injury? J Trauma. 67:531–536. 2009. View Article : Google Scholar : PubMed/NCBI
5	Mondorf Y, Abu-Owaimer M, Gaab MR and Oertel JM: Chronic subdural hematoma - craniotomy versus burr hole trepanation. Br J Neurosurg. 23:612–616. 2009. View Article : Google Scholar : PubMed/NCBI
6	Chisari C, Bertolucci F, Dalise S and Rossi B: Chronic muscle stimulation improves muscle function and reverts the abnormal surface EMG pattern in myotonic dystrophy: A pilot study. J Neuroeng Rehabil. 10:942013. View Article : Google Scholar : PubMed/NCBI
7	Johnson MJ, Bland JM, Davidson PM, et al: The relationship between two performance scales: New York Heart Association Classification and Karnofsky Performance Status Scale. J Pain Symptom Manage. 47:652–658. 2014. View Article : Google Scholar : PubMed/NCBI
8	Amin ST, Morrow DA, Braunwald E, et al: Dynamic TIMI risk score for STEMI. J Am Heart Assoc. 2:e0032692013. View Article : Google Scholar : PubMed/NCBI
9	Bulters D and Belli A: A prospective study of the time to evacuate acute subdural and extradural haematomas. Anaesthesia. 64:277–281. 2009. View Article : Google Scholar : PubMed/NCBI
10	Saver JL: Time is brain - quantified. Stroke. 37:263–266. 2006. View Article : Google Scholar : PubMed/NCBI
11	Flint AC, Gean AD, Manley GT, et al: Temporizing treatment of hyperacute subdural hemorrhage by subdural evacuation port system placement. J Neurosurg. 115:844–848. 2011. View Article : Google Scholar : PubMed/NCBI
12	Sagher O: Acute subdural hematoma. J Neurosurg. 115:8422011. View Article : Google Scholar : PubMed/NCBI
13	Leitgeb J, Mauritz W, Brazinova A, Janciak I, Majdan M, Wilbacher I and Rusnak M: Outcome after severe brain trauma due to acute subdural hematoma. J Neurosurg. 117:324–333. 2012. View Article : Google Scholar : PubMed/NCBI
14	Hatashita S, Koga N, Hosaka Y and Takagi S: Acute subdural hematoma: severity of injury, surgical intervention and mortality. Neurol Med Chir (Tokyo). 33:13–18. 1993. View Article : Google Scholar : PubMed/NCBI
15	Gennarelli TA, Spielman GM, Langfitt TW, Gildenberg PL, Harrington T, Jane JA, Marshall LF, Miller JD and Pitts LH: Influence of the type of intracranial lesion on outcome from severe head injury. J Neurosurg. 56:26–32. 1982. View Article : Google Scholar : PubMed/NCBI