Abstract
Extra dural hematomas (EDH) are usually characterized by a rapidly progressing clinical
course within several hours. Surgical management of EDH with hypothyroidism is a challenging
issue in emergency hour, as the ultimate outcome depends on the time since trauma,
the interval between admittance and operation, associated co-morbidities and the location
of hematomas. We received a 55 yr old woman with Rt. Temporoparietal EDH with significant
mass effect on examination revealed some of the clinical findings, but not the goiter,
of hypothyroidism being confirmed on thyroid function test. Accordingly, we planned
for craniotomy with evacuation of extra-dural blood clots ↓ local anesthesia (LA),
with immediate post-operative l-Thyroxine supplementation through Ryle’s tube. Thus, thorough clinical knowledge
on general examination will help sensitize the neurosurgeon to exclude common co-morbidities,
e.g. hypothyroidism in our case, while focusing on surgical and anesthetic aspects
of relevance of the surgically planned traumatic brain injury cases.
Keywords
Extra dural hematoma - Hypothyroidism -
l-Thyroxine - Euthyroid - Local anesthesia
