- Burr-Hole Trephination of an Acute Subdural Hematoma with Idiopathic Thrombocytopenic Purpura: A Case Report
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Jiin Kang, Keumseok Bae, Jinsu Pyen, Jongyun Kim, Sungmin Cho, Kum Whang, Sohyun Kim, Jiwoong Oh
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J Trauma Inj. 2013;26(3):238-242.
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 Abstract
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- Idiopathic thrombocytopenic purpura (ITP) is the condition of having an abnormally low platelet count with an unknown cause. Acute subdural hematomas (ASDHs) usually develop in trauma patients and often involve a high bleeding tendency. However, ITP patients rarely have a large ASDH, and when a traditional decompressive craniectomy is performed on patients with coagulopathy, the mortality rate is higher because of the greater bleeding risk. We report the case of an ITP patient with a large ASDH who treated with a burr-hole trephination and irrigation and who was discharged without any neurological deficit.
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Summary
- Delayed Traumatic Intracerebral Hemorrhage in Patient with Hemoperitoneum Operation
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Sohyun Kim, Keumseok Bae, Jinsu Pyen, Jongyun Kim, Sungmin Cho, Hany Noh, Kum Whang, Jiwoong Oh
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J Trauma Inj. 2013;26(3):233-237.
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- Delayed traumatic intracerebral hemorrhage (DT-ICH) is a rare event in head trauma patients. However, it develops unexpectedly and results in very severe brain damage. Thus, close monitoring of the neurologic status is needed for every trauma patient. Sometimes, however, neurologic monitoring cannot be done because of sedation, especially in cases of abdominal surgery. In this case report, we describe the case of a 37-yr-old, male patients who had hemoperitoneum because of spleen and renal injury. At the initial operation, massive bleeding was found, so gauze-packing surgery was done first. After the first operation, we sedated the patient for about two days, after which the packed gauze was removed, and the abdominal wound was closed. Immediately after the second operation, we found pupil dilation. Emergent CT was performed. The CT revealed DT-ICH with severe brain edema and midline shifting. However, the patient condition deteriorated progressively despite emergency operation, he expired 2 days after hematoma evacuation.
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