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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
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Surgery for bilateral large intracranial traumatic hematomas: evacuation in a single session
Heng Kompheak1, Sun-Chul Hwang2, Dong-Sung Kim2
1Department of Neurosurgery, Siem Reap Provincial Hospital, Siem Reap, Cambodia.
Journal of Korean Neurosurgical Society
|September 20, 2014
Summary
Bilateral traumatic intracranial hematomas requiring single-session surgery are rare. Epidural hematomas (EDH) are common and should be surgically addressed first, followed by the contralateral hematoma.
Area of Science:
- Neurosurgery
- Trauma Surgery
Background:
- Optimal management for multiple intracranial hematomas remains unclear.
- Guidelines exist for single hematoma evacuation, but not for bilateral cases.
Purpose of the Study:
- To discuss the effective surgical management of bilateral traumatic supratentorial hematomas in a single anesthesia session.
- To present a case series of patients undergoing simultaneous evacuation of bilateral intracranial hematomas.
Main Methods:
- A retrospective review of 203 patients undergoing acute intracranial hematoma evacuation over 5 years.
- Analysis of eight patients (3.9%) who underwent simultaneous bilateral hematoma evacuation.
- Evaluation of injury mechanisms, initial GCS, lesion types, surgical techniques, and outcomes.
Main Results:
- Falls were the most common injury mechanism (4/8 cases).
- Common lesion combinations included epidural hematoma (EDH)/intracerebral hematoma (ICH) (5/8).
- All patients except one survived, with EDH addressed first in all cases.
Conclusions:
- Simultaneous surgical evacuation of bilateral intracranial hematomas is infrequent.
- Epidural hematomas are prevalent in these cases and require initial surgical management.
- Contralateral hematomas can be evacuated subsequently via small craniotomy.
