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Cortical membranectomy in chronic subdural hematoma: Report of two cases.

Altinel F, Altin C, Gezmis E, Altinors N - Asian J Neurosurg (2015 Jul-Sep)

Bottom Line: We present two cases of CSDH, which caused neurological deficits.In both cases cortical membranectomy was performed following craniotomy.After this procedure, significant improvement was observed in patients neurological deficits.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Faculty of Medicine, University of Baskent, İzmir, Turkey.

ABSTRACT
Different surgical procedures have been used in the management of chronic subdural hematoma (CSDH). Nowadays treatment with burr hole is more preferable than craniotomy in most clinics. We present two cases of CSDH, which caused neurological deficits. In both cases cortical membranectomy was performed following craniotomy. After this procedure, significant improvement was observed in patients neurological deficits. We recommend that craniotomy and subtotal membranectomy may be a more adequate choice in such cases. This report underlined that craniotomy is still an acceptable, safe, efficient and even a better procedure in selected patients with CSDH.

No MeSH data available.


Related in: MedlinePlus

Postoperative axial nonenhanced computerized tomography scan shows reexpansion of brain parenchyma without any residual/recurrent subdural hematoma and arrows show craniotomy defects
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Figure 3: Postoperative axial nonenhanced computerized tomography scan shows reexpansion of brain parenchyma without any residual/recurrent subdural hematoma and arrows show craniotomy defects

Mentions: A 74-year-old female patient was referred to our Neurosurgery Department with complaints of dysphasia, unreasonable crying and right hemiplegia. Weakness in the right arm and leg deteriorated during last month. According to her medical history; she was diagnosed with Alzheimer's disease and was under antiAlzheimer medication. Neurological examination revealed orientation disorder and hemiplegia in the right upper and lower extremities. Apart from this, nazolabial sulcus was not seen clearly on the right side of her face. On the CT scan, which was performed 6 months ago; a hypodense lesion on the left hemisphere, with a diameter of 4–5 cm, was noticed. Moreover cortical sulci were not seen clearly and minimal shift to the right side was also noticed. On both CT and magnetic resonance imaging (MRI) scan, CSDH on the left frontotemporal localization (approximately 5 cm) with cortical membrane, which compressed brain parenchyma was detected [Figure 2]. Patient was successfully operated. After the operation reexpansion of brain parenchyma without any residual subdural hematoma (SDH) was seen on CT scan [Figure 3].


Cortical membranectomy in chronic subdural hematoma: Report of two cases.

Altinel F, Altin C, Gezmis E, Altinors N - Asian J Neurosurg (2015 Jul-Sep)

Postoperative axial nonenhanced computerized tomography scan shows reexpansion of brain parenchyma without any residual/recurrent subdural hematoma and arrows show craniotomy defects
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553742&req=5

Figure 3: Postoperative axial nonenhanced computerized tomography scan shows reexpansion of brain parenchyma without any residual/recurrent subdural hematoma and arrows show craniotomy defects
Mentions: A 74-year-old female patient was referred to our Neurosurgery Department with complaints of dysphasia, unreasonable crying and right hemiplegia. Weakness in the right arm and leg deteriorated during last month. According to her medical history; she was diagnosed with Alzheimer's disease and was under antiAlzheimer medication. Neurological examination revealed orientation disorder and hemiplegia in the right upper and lower extremities. Apart from this, nazolabial sulcus was not seen clearly on the right side of her face. On the CT scan, which was performed 6 months ago; a hypodense lesion on the left hemisphere, with a diameter of 4–5 cm, was noticed. Moreover cortical sulci were not seen clearly and minimal shift to the right side was also noticed. On both CT and magnetic resonance imaging (MRI) scan, CSDH on the left frontotemporal localization (approximately 5 cm) with cortical membrane, which compressed brain parenchyma was detected [Figure 2]. Patient was successfully operated. After the operation reexpansion of brain parenchyma without any residual subdural hematoma (SDH) was seen on CT scan [Figure 3].

Bottom Line: We present two cases of CSDH, which caused neurological deficits.In both cases cortical membranectomy was performed following craniotomy.After this procedure, significant improvement was observed in patients neurological deficits.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Faculty of Medicine, University of Baskent, İzmir, Turkey.

ABSTRACT
Different surgical procedures have been used in the management of chronic subdural hematoma (CSDH). Nowadays treatment with burr hole is more preferable than craniotomy in most clinics. We present two cases of CSDH, which caused neurological deficits. In both cases cortical membranectomy was performed following craniotomy. After this procedure, significant improvement was observed in patients neurological deficits. We recommend that craniotomy and subtotal membranectomy may be a more adequate choice in such cases. This report underlined that craniotomy is still an acceptable, safe, efficient and even a better procedure in selected patients with CSDH.

No MeSH data available.


Related in: MedlinePlus