Open AccessTreatment of chronic subdural hematoma in a patient with a left ventricular assist device: Case report and review of the literature
Author(s) -
Gnel Pivazyan,
Mitchell Rock,
Ehsan Dowlati,
C. Jeffrey,
Roger A. Mason
Publication year - 2022
Publication title -
brain circulation
Language(s) - English
Resource type - Journals
eISSN - 2455-4626
pISSN - 2394-8108
DOI - 10.4103/bc.bc_74_21
Subject(s) - medicine , chronic subdural hematoma , hematoma , coagulopathy , embolization , surgery , middle meningeal artery , midline shift
Patients with left ventricular assist devices (LVADs) provide a unique challenge with regard to the management of subdural hematomas (SDH), due to preexisting comorbidities and induced coagulopathy. We report on the case of a 63-year-old female with a preexisting LVAD who developed an acute on chronic SDH with 15 mm of midline shift. She was successfully treated with middle meningeal artery (MMA) embolization and placement of a bedside subdural evacuating port system without hematoma recurrence at 1-year follow-up. Both operative and nonoperative management of SDHs in patients with LVAD is associated with high risk of mortality and morbidity. Chronic SDHs in this patient population can be successfully managed with a minimally invasive approach that includes MMA embolization and bedside subdural drain placement.