Korean J Neurotrauma.  2018 Oct;14(2):142-145. 10.13004/kjnt.2018.14.2.142.

Burr Hole Drainage with Urokinase Irrigation for the Treatment of Acute Subdural Hematoma: A Case Report

Affiliations
  • 1Department of Neurosurgery, Chungnam National University Hospital, Chungnam National University Medical School, Daejeon, Korea. swonchoi@cnuh.co.kr

Abstract

We describe the case of a patient with an acute subdural hematoma (SDH) that was removed using urokinase irrigation after burr hole trephination in a limited situation where craniotomy was not possible. A 90-year-old woman was admitted to our hospital with a stuporous mental status. Computed tomography (CT) scans revealed a chronic SDH, and a burr hole procedure was performed. The patient's postoperative progression was good until the third day after surgery when we found that the acute SDH had increased on CT scans. The patient's guardian refused further surgery, and thus we drained the blood from the hematoma by injecting urokinase through a drainage catheter. We used urokinase for two days, and removed the catheter after confirming via CT scans that the hematoma was almost alleviated. The patient recovered gradually; she was discharged with few neurological deficits.

Keyword

Acute subdural hematoma; Drainage; Urokinase

MeSH Terms

Aged, 80 and over
Catheters
Craniotomy
Drainage*
Female
Hematoma
Hematoma, Subdural, Acute*
Humans
Stupor
Tomography, X-Ray Computed
Trephining
Urokinase-Type Plasminogen Activator*
Urokinase-Type Plasminogen Activator
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