Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis
A 49-year-old man with end-stage renal disease was admitted to the hospital with a severe headache and vomiting. On neurological examination the Glasgow Coma Scale (GCS) score was 15 and his brain CT showed acute subdural hematoma over the right cerebral convexity with approximately 11-mm thickness...
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2014-05-01
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| Series: | Korean Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | http://www.kjccm.org/upload/pdf/kjccm-2014-29-2-114.pdf |
| _version_ | 1828404631764467712 |
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| author | Chul Hee Lee |
| author_facet | Chul Hee Lee |
| author_sort | Chul Hee Lee |
| collection | DOAJ |
| description | A 49-year-old man with end-stage renal disease was admitted to the hospital with a severe headache and vomiting. On neurological examination the Glasgow Coma Scale (GCS) score was 15 and his brain CT showed acute subdural hematoma over the right cerebral convexity with approximately 11-mm thickness and 9-mm midline shift. We chose a conservative treatment of scheduled neurological examination, anticonvulsant medication, serial brain CT scanning, and scheduled hemodialysis (three times per week) without using heparin. Ten days after admission, he complained of severe headache and a brain CT showed an increased amount of hemorrhage and midline shift. Emergency burr hole trephination and removal of the hematoma were performed, after which symptoms improved. However, nine days after the operation a sudden onset of general tonic-clonic seizure developed and a brain CT demonstrated an increased amount of subdural hematoma. Under the impression of persistent increased intracranial pressure, the patient was transferred to the intensive care unit (ICU) in order to control intracranial pressure. Management at the ICU consisted of regular intravenous mannitol infusion assisted with continuous renal replacement therapy. He stayed in the ICU for four days. Twenty days after the operation he was discharged without specific neurological deficits. |
| first_indexed | 2024-12-10T10:39:28Z |
| format | Article |
| id | doaj.art-2b7affd414704a789b771074f7c54cd2 |
| institution | Directory Open Access Journal |
| issn | 2383-4870 |
| language | English |
| last_indexed | 2024-12-10T10:39:28Z |
| publishDate | 2014-05-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Korean Journal of Critical Care Medicine |
| spelling | doaj.art-2b7affd414704a789b771074f7c54cd22022-12-22T01:52:20ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-48702014-05-0129211411810.4266/kjccm.2014.29.2.114142Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during HemodialysisChul Hee LeeA 49-year-old man with end-stage renal disease was admitted to the hospital with a severe headache and vomiting. On neurological examination the Glasgow Coma Scale (GCS) score was 15 and his brain CT showed acute subdural hematoma over the right cerebral convexity with approximately 11-mm thickness and 9-mm midline shift. We chose a conservative treatment of scheduled neurological examination, anticonvulsant medication, serial brain CT scanning, and scheduled hemodialysis (three times per week) without using heparin. Ten days after admission, he complained of severe headache and a brain CT showed an increased amount of hemorrhage and midline shift. Emergency burr hole trephination and removal of the hematoma were performed, after which symptoms improved. However, nine days after the operation a sudden onset of general tonic-clonic seizure developed and a brain CT demonstrated an increased amount of subdural hematoma. Under the impression of persistent increased intracranial pressure, the patient was transferred to the intensive care unit (ICU) in order to control intracranial pressure. Management at the ICU consisted of regular intravenous mannitol infusion assisted with continuous renal replacement therapy. He stayed in the ICU for four days. Twenty days after the operation he was discharged without specific neurological deficits.http://www.kjccm.org/upload/pdf/kjccm-2014-29-2-114.pdfacute subdural hematomaend stage renal diseasehemodialysisrenal replacement therapy |
| spellingShingle | Chul Hee Lee Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis Korean Journal of Critical Care Medicine acute subdural hematoma end stage renal disease hemodialysis renal replacement therapy |
| title | Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis |
| title_full | Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis |
| title_fullStr | Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis |
| title_full_unstemmed | Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis |
| title_short | Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis |
| title_sort | selection of treatment for large non traumatic subdural hematoma developed during hemodialysis |
| topic | acute subdural hematoma end stage renal disease hemodialysis renal replacement therapy |
| url | http://www.kjccm.org/upload/pdf/kjccm-2014-29-2-114.pdf |
| work_keys_str_mv | AT chulheelee selectionoftreatmentforlargenontraumaticsubduralhematomadevelopedduringhemodialysis |