Trial of a new operative method for recurrent chronic subdural hematoma

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✓ A new operative method for treating recurrent chronic subdural hematoma is presented. This method consists of complete obliteration of the subdural hematoma cavity and conversion of the hematoma cavity into epidural space. The procedure was carried out in three patients with recurrent chronic subdural hematoma, all of whom made a complete recovery.

Article Information

Address reprint requests to: Yuzuru Oku, M.D., Department of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo 660, Japan.

© AANS, except where prohibited by US copyright law.

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    Left: Computerized tomography scan showing an isodense chronic subdural hematoma on the right side. Center: Scan taken 8 days after operation. The size of the hematoma cavity and the midline shift were markedly reduced after the evacuation of the hematoma. Right: Scan taken 1 month after surgery showing marked midline shift due to a recurrent isodense subdural hematoma.

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    Schematic representation of the surgical procedure. Upper: Preoperative view of the chronic subdural hematoma. Center: The hematoma is evacuated through a craniotomy. The margin of the external membrane is left attached to the dura mater. Lower: The dura is stripped from the skull. The hematoma cavity is completely obliterated and converted to epidural space.

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    Computerized tomography scan 3 months after operation showing complete cure of the subdural hematoma.

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    Left: Computerized tomography scan showing a recurrent chronic subdural hematoma at the left frontal area. Center: Scan taken 8 days after operation. The left frontal low-density area is probably a subdural collection. Right: Scan 3 months after operation showing complete absorption of both the epidural and subdural collections.

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