Journal of Korean Neurosurgical Society
- Volume 29 Issue 5
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- Pages.659-663
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- 2000
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
Emergency Trephination Site of Acute Subdural Hematoma
급성 경막하 혈종에서 응급 두개골 천공의 위치
- Moon, Soo-Hyeon (Department of Neurosurgery, College of Medicine, Korea University) ;
- Kim, Geun-Hoe (Department of Neurosurgery, College of Medicine, Korea University) ;
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Kwon, Taek-Hyun
(Department of Neurosurgery, College of Medicine, Korea University) ;
- Park, Youn-Kwan (Department of Neurosurgery, College of Medicine, Korea University) ;
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Chung, Hung-Seob
(Department of Neurosurgery, College of Medicine, Korea University) ;
- Suh, Jung-Keun (Department of Neurosurgery, College of Medicine, Korea University)
- 문수현 (고려대학교 의과대학 신경외과학교실) ;
- 김근회 (고려대학교 의과대학 신경외과학교실) ;
-
권택현
(고려대학교 의과대학 신경외과학교실) ;
- 박윤관 (고려대학교 의과대학 신경외과학교실) ;
-
정흥섭
(고려대학교 의과대학 신경외과학교실) ;
- 서중근 (고려대학교 의과대학 신경외과학교실)
- Received : 1999.09.02
- Accepted : 1999.10.26
- Published : 2000.05.28
Abstract
The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.