Usefulness of an alternative option for evacuation of acute subdural hematoma: The toothbrush curettage method

Okuma, Yu; Hirotsune, Nobuyuki; Sotome, Yuta; Kegoya, Yasuhito; Matsuda, Yuki; Sato, Yu; Tanabe, Tomoyuki; Muraoka, Kenichiro; Nishino, Shigeki

doi:10.1016/j.neuchi.2020.08.005

Cited by 1 publication

(1 citation statement)

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“…Fronto-parieto-temporal craniotomy was performed along the gutter by dural scissors, leaving the muscle and base of the temporal bone as a hinge. Inverting the bone flap along this guttered hinge, likewise inverted gull wing, we widely exposed the brain surface to search for the site of bleed and achieved hemostasis by toothbrush curettage technique,[ 2 ] avoiding cauterization as much as possible. Expansive duraplasty was performed using Gore-Tex artificial dura, the bone flap was left without anything further, and we closed a surgical incision politely [ Supplementary Video 1 ].…”

Section: Case Reportmentioning

confidence: 99%

Inverted gull-wing hinge decompressive craniotomy for infantile acute subdural hematoma

Okuma¹,

Yasuhara²,

Kin³

et al. 2023

Brain Circulation

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Infantile severe acute subdural hematomas (ASDHs) usually require a decompressive craniotomy. However, these infantile patients often suffer surgical site infection and aseptic bone-flap resorption after external decompression. In this report, we showed a case of a simplified hinge decompressive craniotomy in an infant with severe ASDH. A 2-month-old girl suffered from status epilepticus, impaired consciousness, multiple rib fractures, bilateral fundus hemorrhage, and a right ASDH. We performed a simplified hinge decompressive craniotomy, making a vascularized bone flap with a hinge using the partial temporal bone and temporal muscle and not fixing the bone flap like an inverted gull wing. Cranioplasty was performed 4 weeks after the decompression craniotomy with replaced resorbable substitute dura. Six months after the transfer, her development was generally in line with her age. The decompressive craniotomy with an inverted gull-wing hinge has shown a good outcome.

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Section: Case Reportmentioning

confidence: 99%