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.
Keywords
acute subdural hematoma - burr hole drainage - coagulopathy - thrombocytopenia
