Open AccessEndoscopic hematoma evacuation for acute subdural hematoma in a young patient: a case report
Author(s) -
Kuge Atsushi,
Tsuchiya Daisuke,
Watanabe Shigeki,
Sato Mitsuya,
Kinjo Toshihiko
Publication year - 2017
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.295
Subject(s) - anisocoria , medicine , acute subdural hematoma , craniotomy , hematoma , surgery , midline shift , decompressive craniectomy , anesthesia , traumatic brain injury , pupil , neuroscience , psychiatry , biology
Case The standard treatment for acute subdural hematoma (ASDH) is large craniotomy; decompressive craniectomy may also be carried out, if needed, to prevent secondary brain damage. Recently, an endoscopic procedure for elderly patients with ASDH was carried out and reported; its safety and effectiveness were emphasized because of minimal invasiveness. We report a young case and discuss its difficulties and tips. A 31‐year‐old man was found to be in a state of general convulsion. At the time of admission, we observed severe consciousness disturbance, anisocoria, and left hemiparesis. Computed tomography showed a massive subdural hematoma with marked midline shift. Outcome Osmotherapy and emergency trepanation improved anisocoria. An endoscopic procedure under local anesthesia was sequentially selected. After surgery, the patient's symptoms clearly improved. Conclusion Although the standard treatment for ASDH is craniotomy, endoscopic surgery may be useful in some cases.