Document Detail


Novel method for emergency craniostomy for rapid control and monitoring of the intracranial pressure in severe acute subdural hematoma.
MedLine Citation:
PMID:  21123995     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Acute subdural hematoma (ASDH) is a critical condition following the onset of traumatic brain injury, and it is essential to immediately reduce elevated intracranial pressure (ICP). Single burr hole surgery/twist drill craniostomy is commonly performed in patients with ASDH as an emergency surgical intervention, usually preceding decompressive craniotomy. A novel method using a cerebrospinal fluid (CSF) drainage catheter kit for rapid drainage of ASDH is described. Percutaneous twist drill craniostomy using a CAMINO(®) micro ventricular bolt pressure-temperature monitoring kit was performed in the emergency room in 12 patients with severe ASDH. The kit contained a closed-system CSF drainage and pressure-temperature monitoring catheter, which allowed aspiration of the hematoma and monitoring of the ICP. The tip of the catheter was inserted into the hematoma from the forehead. The mean initial ICP was 61 mmHg, with a range of 31 to 120 mmHg. The liquid hematoma was aspirated, and the ICP was temporarily controlled to the normal range. Pupil dilation recovered immediately after aspiration of the hematoma in 3 patients. No complications occurred either during or after the operation. This new method for craniostomy is easy, safe, and effective to monitor and rapidly control ICP in the emergency room. This technique also offers the possibility of evaluating the patient's prognosis and determining indications for further decompressive craniectomy by the continuation of ICP control under ICP monitoring and evaluation of the reversibility of pupillary findings in ASDH patients.
Authors:
Yuko Mihara; Kenji Dohi; Shunsuke Nakamura; Yasufumi Miyake; Tohru Aruga
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurologia medico-chirurgica     Volume:  50     ISSN:  1349-8029     ISO Abbreviation:  Neurol. Med. Chir. (Tokyo)     Publication Date:  2010  
Date Detail:
Created Date:  2010-12-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400775     Medline TA:  Neurol Med Chir (Tokyo)     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1039-44     Citation Subset:  IM    
Affiliation:
Department of Emergency and Critical Care Medicine, Showa University School of Medicine, Tokyo, Japan.
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