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Endoscopic surgery for traumatic acute subdural hematoma.

Hiroyuki Kon1, Atsushi Saito1, Hiroki Uchida1

  • 1Department of Neurosurgery, Aomori Prefectural Central Hospital, Aomori, Japan.

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Summary

Endoscopic surgery using local anesthesia successfully treated acute subdural hematoma in an elderly patient. This minimally invasive approach offers a viable alternative to craniotomy for traumatic intracranial hematomas.

Keywords:
Acute subdural hematomaEndoscopic surgeryTrauma

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Area of Science:

  • Neurosurgery
  • Minimally Invasive Procedures
  • Traumatic Brain Injury Management

Background:

  • Traumatic acute subdural hematoma (ASDH) typically requires craniotomy under general anesthesia.
  • Elderly patients with comorbidities present unique challenges for surgical intervention.
  • Previous interventions included coil embolization for aneurysm and ventriculoperitoneal shunt placement.

Observation:

  • An 87-year-old female presented with altered consciousness and hemiplegia after head trauma.
  • Computed tomography revealed a significant left-frontotemporal ASDH.
  • The patient's advanced age and condition precluded traditional craniotomy.

Findings:

  • One-burr-hole endoscopic surgery was performed under local anesthesia.
  • Endoscopic evacuation of the ASDH was achieved, and the bleeding source was coagulated.
  • Postoperative imaging confirmed hematoma reduction without complications.
  • The patient experienced immediate improvement in neurological deficits.

Implications:

  • Endoscopic evacuation of traumatic ASDH is a feasible alternative to craniotomy, especially in high-risk elderly patients.
  • This minimally invasive technique may reduce surgical risks and recovery time.
  • Further research is warranted to establish the broader applicability of endoscopic ASDH treatment.