Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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15-AUGUST-2013 SAAD SULAYMAN AL-HWEDY 86 YEARS
WELL ORGANIZED THICK CHRONIC SUBDURAL HEMATOMA UNWILLING TO REMOVAL BY BURR
HOLES AND EXTERNAL DRAIN.
Anamnesis
The patient was operated by me 13-August-2013
for chronic subdural hematoma left convexity and
sent to the ICU with external drain. In the
first 6-8 hours only 60 ml dark blood came out
and CT-scan done 12 and 36 hours after surgery
showed still huge subdural hematoma of the left
cerebral convexity. The patient right sided
weakness resolved and despite the preserved
clinical status, it was planned to perform
craniotomy to remove the thick hematoma.
Using the burr holes created
at the first surgery, craniotomy over the left
parietal region was done with reflection of the
bone flap to the left ear. The hematoma wall was
very thick with solid hematoma inside the
capsule. The external layer of the capsule was
removed so the sold hematoma was evacuated. The
dura was water-tightly closed and the bone flap
returned to its place. Routine closure of the
wound.
Smooth postoperative
recovery. The patient was sent to the ICU.
Comments
The patient has thick hematoma requiring
craniotomy. Burr holes and external drain failed
to achieve the needed goal.
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