Endoscopic Burr Hole Surgery with a Curettage and Suction Technique to Treat Traumatic Subacute Subdural Hematomas

Abstract

Background Traumatic subacute subdural hematomas can usually be evacuated via craniotomy under general anesthesia. We report a traumatic subacute subdural hematoma in an elderly patient that was evacuated by endoscopic burr hole surgery using a curettage and suction technique under local anesthesia. This minimally invasive neurosurgery may lower the morbidity rate in elderly or sick patients with serious cardiac and/or pulmonary lesions in whom the inherent risks of general anesthesia are high.

Patient An 88-year-old man was referred to our institution with left hemiparesis 6 days after sustaining a head injury. He was on antiplatelet drugs for severe coronary and peripheral artery disease and underwent hemodialysis three times a week.

Results Endoscopic burr hole surgery using a curettage and suction technique resulted in the complete evacuation of his subacute subdural hematoma and complete hemostasis, and he recovered completely.

Conclusion Endoscopic burr hole surgery using a curettage and suction technique is a minimally invasive treatment to address subacute subdural hematomas. This method may be particularly useful in older patients in whom general anesthesia poses additional risks.

Keywords

subacute subdural hematoma - endoscope - curettage and suction technique - minimally invasive neurosurgery

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