Emergency surgical management strategy for extra dural hematoma with pre-existing undiagnosed hypothyroidism: A case report

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

Publication History

Received: 07 May 2013

Accepted: 22 November 2013

Publication Date:
06 April 2017 (online)

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