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Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures

Postoperative epidural hematoma (POEDH) is a known complication after neurosurgical procedures. Large POEDHs are life-threatening and require emergency evacuation, and open surgery is the mainstay of treatment. Most of POEDHs are hyperdense on computed tomography (CT). We herein report a subset of P...

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Autores principales: Ren, Hecheng, Yin, Long, Ma, Lin, Wei, Ming, Ma, Xiaodong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078748/
https://www.ncbi.nlm.nih.gov/pubmed/30045271
http://dx.doi.org/10.1097/MD.0000000000011475
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author Ren, Hecheng
Yin, Long
Ma, Lin
Wei, Ming
Ma, Xiaodong
author_facet Ren, Hecheng
Yin, Long
Ma, Lin
Wei, Ming
Ma, Xiaodong
author_sort Ren, Hecheng
collection PubMed
description Postoperative epidural hematoma (POEDH) is a known complication after neurosurgical procedures. Large POEDHs are life-threatening and require emergency evacuation, and open surgery is the mainstay of treatment. Most of POEDHs are hyperdense on computed tomography (CT). We herein report a subset of POEDHs requiring evacuation, which presented with isodense features on CT. The presenting symptoms of patients were severe headache accompanied by nausea and vomiting as well as unilateral limb weakness (n = 1) and consciousness disorder (n = 4). The Glasgow coma score of the patients was 8.4 ± 3.5. All patients underwent emergency bedside burr hole evacuation through a tube, rather than open surgery. The meantime for the bedside procedures is 6.0 ± 1.5 minutes. All 5 POEDHs were proven liquid and evacuated successfully. All patients recovered quickly with good outcomes. We concluded that the isodensity of the POEDHs on CT represent their liquid nature. Bedside burr hole evacuation through a tube may be a recommendable method for this subset of POEDHs requiring evacuation. Thus, an open surgery and general anesthesia may be avoided.
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spelling pubmed-60787482018-08-13 Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures Ren, Hecheng Yin, Long Ma, Lin Wei, Ming Ma, Xiaodong Medicine (Baltimore) Research Article Postoperative epidural hematoma (POEDH) is a known complication after neurosurgical procedures. Large POEDHs are life-threatening and require emergency evacuation, and open surgery is the mainstay of treatment. Most of POEDHs are hyperdense on computed tomography (CT). We herein report a subset of POEDHs requiring evacuation, which presented with isodense features on CT. The presenting symptoms of patients were severe headache accompanied by nausea and vomiting as well as unilateral limb weakness (n = 1) and consciousness disorder (n = 4). The Glasgow coma score of the patients was 8.4 ± 3.5. All patients underwent emergency bedside burr hole evacuation through a tube, rather than open surgery. The meantime for the bedside procedures is 6.0 ± 1.5 minutes. All 5 POEDHs were proven liquid and evacuated successfully. All patients recovered quickly with good outcomes. We concluded that the isodensity of the POEDHs on CT represent their liquid nature. Bedside burr hole evacuation through a tube may be a recommendable method for this subset of POEDHs requiring evacuation. Thus, an open surgery and general anesthesia may be avoided. Wolters Kluwer Health 2018-07-27 /pmc/articles/PMC6078748/ /pubmed/30045271 http://dx.doi.org/10.1097/MD.0000000000011475 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Ren, Hecheng
Yin, Long
Ma, Lin
Wei, Ming
Ma, Xiaodong
Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
title Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
title_full Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
title_fullStr Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
title_full_unstemmed Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
title_short Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
title_sort emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6078748/
https://www.ncbi.nlm.nih.gov/pubmed/30045271
http://dx.doi.org/10.1097/MD.0000000000011475
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