Indian Journal of Neurotrauma 2015; 12(01): 019-022
DOI: 10.1055/s-0035-1554949
Original Article
Neurotrauma Society of India

Emergent Burr Hole Drainage of Traumatic Acute Subdural Hematoma with Drain Placement in Preexisting Coagulopathy Showing Rapid Neurological Deterioration: A Novel Technique

Guru Dutta Satyarthee
1   Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
,
P. Chouksey
1   Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
,
P. Singh
1   Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Agrawal
1   Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
,
Hitesh Gurjar
1   Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

16 June 2014

02 December 2014

Publication Date:
30 June 2015 (online)

Abstract

Aim The aim of this article is to investigate the efficacy of emergency burr hole drainage of significantly thicker acute subdural hematoma (ASDH) with coagulopathy.

Patient and Methods A 23-year-old man presented with ASDH of left fronto-temporo-parietal region due to trauma following trivial injury. Patient was chronic alcoholic having coagulopathy and thrombocytopenia. He had rapid deterioration in neurological status. Though craniotomy and hematoma evacuation was planned initially, in view of persistent coagulopathy, emergent burr hole evacuation was performed. Neurological symptoms improved dramatically after the burr hole evacuation. He became alert and could walk unassisted 3 days after surgery, although psychic disturbance resulting from cerebral contusion persisted.

Result Burr hole evacuation is an useful treatment for significant thicker ASDH with coagulopathy, as procedure can be performed easily and rapidly, aids in achieving reduction of intracranial pressure while purchasing time for correction of coagulopathy.

Conclusion Emergency burr hole drainage should be considered in rapidly deteriorating patients with significant thicker ASDH with persistent thrombocytopenia and coagulopathy showing rapid neurological deterioration.