title: Combined endovascular and endoscopic surgery for acute epidural hematoma in a patient with poor health.
abstract: A 74-year-old woman presented with right acute epidural hematoma (AEDH) associated with a skull fracture after a fall. Emergency craniotomy under general anesthesia could not be performed because of her poor medical condition. Therefore, transfemoral endovascular embolization and hematoma evacuation via a burr hole were performed using endoscopy under local anesthesia. The patient recovered and was discharged without neurological deficits. AEDH is a common traumatic disease often requiring emergency craniotomy to prevent death and restore neurological function. The present combined surgical approach was effective in treating AEDH that could not be treated under general anesthesia in a patient with poor medical condition.
authors.affiliation: Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan. tomotaka.oshima@toyota-kai.or.jp
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Ohshima
authors.forename: Hayato
authors.initials: H
authors.lastname: Tajima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Fujii
authors.forename: Masamune
authors.initials: M
authors.lastname: Nagakura
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Nishizawa
authors.forename: Kyozo
authors.initials: K
authors.lastname: Kato
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyachi
mesh_terms: D000368:Aged; D000772:Anesthesia, Local; D002533:Cerebral Angiography; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D004630:Emergencies; D005260:Female; D016330:Frail Elderly; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D044583:Neuroendoscopy; D012887:Skull Fractures / Q000150:complications; D013701:Temporal Bone / Q000293:injuries; D014057:Tomography, X-Ray Computed; D014207:Trephining