Emergency bedside evacuation of a subset of large postoperative epidural hematomas after neurosurgical procedures. Issue 30 (July 2018)

• Record Type: Journal Article
• Authors: Ren, Hecheng; Yin, Long; Ma, Lin; Wei, Ming; Ma, Xiaodong
• Other Names: Xiong. Xiaoxing section editor.
• Is Part Of: Medicine. Volume 97:Issue 30(2018)
• Publication Date: 2018-07
• Subjects: burr hole -- emergency evacuation -- epidural hematoma -- isodensity -- postoperative hematoma -- suction drainage; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000011475
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: 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.