title: Single burr hole evacuation for traumatic acute subdural hematoma of the posterior fossa in the emergency room.
abstract: A 57-year-old man and a 55-year-old man presented with acute subdural hematoma of the posterior cranial fossa due to trauma. Both were comatose preoperatively. Emergent single burr hole evacuation in the posterior cranial fossa was performed in the emergency room immediately after computed tomography. Neurological symptoms improved dramatically just after initiating the burr hole evacuation in both patients. A 57-year-old man became alert and could walk unassisted 1 month after surgery. The other could walk with assistance 4 months after surgery, although psychic disturbance resulting from cerebral contusion remained. Single burr hole evacuation in the emergency room is a useful treatment for acute subdural hematoma of the posterior cranial fossa because the procedure can be performed easily and rapidly, thus achieving reduction of intracranial pressure. Progressing neurological deterioration, reversibility of brainstem function by mannitol administration and the sign of brainstem compression and noncommunicating hydrocephalus are good indicators for this treatment.
authors.affiliation: Department of Neurosurgery, Sendai City Hospital, Sendai, Japan. noge@city-hosp.wakabayashi.sendai.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Motohashi
authors.forename: Motonobu
authors.initials: M
authors.lastname: Kameyama
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Shimosegawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Fujimori
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Sugai
authors.forename: Takehide
authors.initials: T
authors.lastname: Onuma
mesh_terms: D004322:Drainage / Q000379:methods*; D004638:Emergency Treatment; D020199:Hematoma, Subdural, Acute / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014207:Trephining