Cerebral Oxygen Dynamics in a Patient After Subdural Haematoma Removal Surgery: A Case Report

Near-infrared spectroscopy (NIRS) can be employed for the non-invasive real-time evaluation of cerebral oxygen dynamics. A portable wireless NIRS system has been developed to record measurements using a band worn around the head. In this case report, we describe the clinical findings and cerebral oxygen dynamics of a patient who underwent surgery to remove a left temporal subdural haematoma. The patient was a male in his 70s, who fell while riding a bicycle. Following the gradual onset of gait disturbance, the patient was admitted to our hospital for surgery. After surgical removal of the subdural haematoma, the cerebral oxygen dynamics of the left and right frontal cortical hemispheres were monitored using NIRS in the following sequence: supine, bed-up 70°, sitting, standing, and supine, for 3 min each. Measurements were made on postoperative days (PODs) 2, 3, 7, and 10. Clinically, on POD2, the patient had a decreased level of consciousness, requiring assistance in maintaining each posture. On POD10, his level of consciousness improved and he was able to walk for short distances. The cerebral oxygen dynamics on the injured hemispheres showed the most remarkable changes on POD2 which decreased with the passage of time. NIRS may be useful in non-invasive assessment of the recovery of the cerebral circulation after neurosurgical intervention to inform the medical rehabilitation team on the progress in recovery.