Delayed acute subdural hematoma treated with endoscopic procedure: A case report

Area of Science:

• Neurosurgery
• Traumatic Brain Injury
• Minimally Invasive Procedures

Background:

• Delayed acute subdural hematoma (DASDH) is characterized by late-onset hematoma without initial abnormal findings.
• The exact mechanism of DASDH remains unclear, and it is a rare complication of traumatic brain injury.
• Endoscopic surgery is emerging as a treatment option for acute subdural hematoma (ASDH).

Observation:

• A 73-year-old male presented with delayed severe headache and mild consciousness disturbance three days after a fall.
• Initial head CT and MRI revealed no abnormalities following the fall.
• Subsequent head CT demonstrated a left acute subdural hematoma (ASDH).

Findings:

• Endoscopic evacuation of the hematoma was performed under local anesthesia.
• Pulsatile bleeding from a cortical artery was identified as the source of the DASDH.
• The patient experienced immediate improvement in consciousness and was discharged without neurological deficit.

Implications:

• This case highlights the potential source of bleeding in DASDH, identified via endoscopic visualization.
• Endoscopic surgery offers a minimally invasive approach for treating ASDH, allowing direct identification of bleeding sources.
• Further research and case studies are needed to better understand DASDH mechanisms and optimize treatment strategies.