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Washington University Experience | VASCULAR | Hemorrrhage - Subdural | 4A0 Case 4 History
Case 4 History ---- This is a 73-year-old man admitted for treatment of a large recurrent right convexity chronic subdural hematoma. The patient was initially seen in December 2010. CT imaging demonstrated a large right-sided subdural hematoma. The patient underwent right frontal and right parietal burr hole drainage of the subdural hematomas. He was transferred for rehabilitation and physical therapy. The patient was noted to have increased lethargy. Repeat CT imaging demonstrated a recurrence of the chronic subdural hematoma, with secondary mass effect. The patient underwent replacement of a subdural catheter in his right subdural space on 12/22. The following day, he had a right craniotomy with drainage of chronic subdural hematoma and partial stripping of subdural membranes. He again deteriorated. CT imaging demonstrated the recurrence of hypodense fluid in the subdural space, and increase in mass effect and right-to-left midline shift. He had an extensive right frontal parietotemporal craniotomy with depressive craniectomy, removal of subdural hematoma, and stripping of membranes. The specimen from that surgery is represented by the provided images.
