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Endoscopic hematoma evacuation for acute subdural hematoma in a young patient: a case report

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 effectiv...

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Detalles Bibliográficos
Autores principales: Kuge, Atsushi, Tsuchiya, Daisuke, Watanabe, Shigeki, Sato, Mitsuya, Kinjo, Toshihiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649296/
https://www.ncbi.nlm.nih.gov/pubmed/29123907
http://dx.doi.org/10.1002/ams2.295
Descripción
Sumario: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.