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[Craniotomy for organized subdural hematoma].

Toshika Ohkawa¹, Mitsuhiro Ogura, Sadayuki Tanaka

¹Department of Neurological Surgery, Wakayama Medical University, Japan.

No Shinkei Geka. Neurological Surgery

|April 16, 2005

Summary

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This study details radical craniotomy for organized chronic subdural hematoma (CSDH) in elderly patients. A novel technique involving dura mater stripping and fibrin glue obliteration prevented recurrence in all three cases.

Area of Science:

Neurosurgery
Neurology

Background:

Organized chronic subdural hematoma (CSDH) presents a surgical challenge, particularly in recurrent or complex cases.
Previous treatments like trephine evacuation may be insufficient for organized CSDH.

Observation:

Three elderly patients (two male, one female) with organized CSDH were treated.
Two patients had a history of intracranial aneurysm surgery (craniotomy and neck clipping).
Multiple prior trephine evacuations had failed to resolve the organized hematoma.

Findings:

Radical treatment via craniotomy and complete hematoma removal, including the thick outer membrane, was performed.
A surgical technique involving stripping the dura mater and securing it with fibrin glue was employed to obliterate the subdural space.

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No recurrences were observed during a follow-up period exceeding two years.

Implications:

This surgical approach offers a potentially effective solution for complex, organized chronic subdural hematomas.
The dura mater manipulation technique may reduce the risk of CSDH recurrence.
Further research into this radical treatment for CSDH is warranted.