PMC5928297_01
Preoperative images, CT scans and MRI showed a CSDH in the right hemisphere with a shift of the midline structures and lateral ventricle compression. A-B: brain CT images; C-D: brain T2-weighted MRI.
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CSDH with a shift of the midline structures and lateral ventricle compression (Fig. 1). Closed-system drainage of the hematoma was performed via one burr hole under general anesthesia.
Closed-system drainage for CSDH after a burrhole craniostomy.
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The drainage system was initiated when she returned to the ICU ward, and the highest point of the drainage system was 15 cm, relative to the midbrain (Fig. 2).
Postoperative CT images, A-C: CT scans revealed an SAH focused on the tentorium cerebella, a parasagittal acute subdural hematoma and a contralateral acute subdural hematoma. The right lateral ventricle compression was markedly reduced, and the midline structure shad generally returned to their original positions. D: The drainage catheter can be seen in the hematoma cavity.
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The right lateral ventricle compression was markedly reduced, and the midline structure had generally returned to the correct position compared to the preoperative image (Fig. 3).
Postoperative CT angiography images, A-D: A CT angiogram showed normal arteries and excluded the presence of intracranial aneurysms.
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CT angiogram excluded the presence of intracranial aneurysms (Fig. 4). Conservative treatments such as pharmacological sedation, hyperventilation, blood component transfusion, and administration of hypertonic saline, osmotic diuretics, human serum albumin, and systemic antibiotics were administered.