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Chronic subdural hematoma under local anesthesia with manual burr hole | JoVE Visualize

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Chronic subdural hematoma under local anesthesia with manual burr hole

Nathan Beucler^1,2, Aurore Sellier³, Cédric Bernard³

¹Neurosurgery Department, Sainte-Anne Military Teaching Hospital, 2 boulevard Sainte-Anne, 83800, Toulon Cedex 9, France. nathan.beucler@neurochirurgie.fr.

Acta Neurochirurgica|March 31, 2021

View abstract on PubMed

Summary

Elderly patients with chronic subdural hematoma (CSH) can safely undergo simplified burr hole evacuation (BHE) under local anesthesia. This minimally invasive technique offers rapid neurological improvement and is valuable for fragile populations or resource-limited settings.

Area of Science:

Neurosurgery
Geriatric Medicine
Minimally Invasive Procedures

Background:

Chronic subdural hematoma (CSH) poses significant risks in elderly patients due to their fragility.
Traditional burr hole evacuation (BHE) for CSH can lead to considerable morbidity and mortality in this demographic.
Military neurosurgeons utilize a simplified BHE technique under local anesthesia with a manual craniotome.

Observation:

An 85-year-old female presented with confusion and left-sided hemiparesis due to a right-sided CSH.
The patient underwent the simplified manual BHE procedure under local anesthesia.

Findings:

The patient experienced immediate neurological improvement post-procedure.
Manual BHE of symptomatic CSH under local anesthesia is a safe and effective intervention.
The technique is particularly beneficial for the very elderly and in situations with strained resources.

Implications:

This simplified BHE technique offers a safe alternative for high-risk elderly patients.
The procedure's efficacy in resource-limited settings highlights its broad applicability.
Training young neurosurgery residents in this manual BHE technique is recommended for wider adoption.

Keywords:

Biomedical Engineering

Neural Engineering

Chronic Subdural Hematoma Under Local Anesthesia With Manual Burr Hole

Burr hole evacuation

Local anesthesia

Manual burr hole

Symptomatic chronic subdural hematoma