+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Novel Minimally Invasive Treatment Strategy for Acute Traumatic Epidural Hematoma: Endovascular Embolization Combined with Drainage Surgery and Use of Urokinase



Novel Minimally Invasive Treatment Strategy for Acute Traumatic Epidural Hematoma: Endovascular Embolization Combined with Drainage Surgery and Use of Urokinase



World Neurosurgery 110: 206-209



Hematoma evacuation is regular treatment for acute traumatic epidural hematoma (ATEDH) patients meeting with surgery indications. However, it is an invasive approach performed under general anesthesia. Here, a novel minimally invasive method of endovascular embolization with subsequent drainage surgery and use of urokinase was established to treat ATEDH under local anesthesia. A novel minimally invasive method of endovascular embolization with subsequent drainage surgery and use of urokinase was established to treat ATEDH under local anesthesia. Firstly, 23 ATEDH patients with hematomas in the temporal area underwent digital subtraction angiography detecting the bleeding point. Next, embolization was performed. After embolization, drainage surgery was taken and urokinase was injected into the hematoma cyst by drainage tube to lyse hematoma twice per day. The results showed that the middle meningeal artery was the bleeding source. Embolization immediately ceased bleeding. Most clots were resolved and drained after treatment. No recurrence of hematoma or infection was observed. The findings suggest that the combined treatments can be an alternative minimally invasive option for ATEDHs, especially for elderly patients or those contraindicated for general anesthesia.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059372879

Download citation: RISBibTeXText

PMID: 29158097

DOI: 10.1016/j.wneu.2017.11.047


Related references

Minimally-invasive aspiration and drainage for management of traumatic epidural hematoma straddling transverse sinus. Neurology India 61(2): 111-116, 2013

Endovascular treatment for traumatic ear bleeding associated with acute epidural hematoma. Neurologia Medico-Chirurgica 48(5): 208-210, 2008

Minimally invasive surgery for acute noncomplicated epidural hematoma: an innovative endoscopic-assisted method. Journal of Trauma and Acute Care Surgery 73(3): 774-777, 2012

Combined Endovascular and Endoscopic Surgery for Acute Epidural Hematoma in a Patient With Poor Health. Neurologia medico-chirurgica 52(11): 829-831, 2012

Combined endovascular and endoscopic surgery for acute epidural hematoma in a patient with poor health. Neurologia Medico-Chirurgica 52(11): 829-831, 2013

Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series. Biomed Research International 2016: 6507350, 2017

Combined minimally invasive techniques to cure accidental dural tears occurring during spine surgery: epidural blood patch associated with cerebrospinal fluid drainage and ventral bed rest. Acta Anaesthesiologica Belgica 67(3): 143-147, 2016

Acute Contralateral Epidural Hematoma Developing during Decompressive Surgery for Traumatic Intracranial Hematoma. Neurologia medico-chirurgica 23(2): 152-156, 1983

Acute contralateral epidural hematoma developing during decompressive surgery for traumatic intracranial hematoma. Report of three cases. Neurologia Medico-Chirurgica 23(2): 152-156, 1983

A Less Invasive Strategy for Ruptured Cerebral Aneurysms with Intracerebral Hematomas: Endovascular Coil Embolization Followed by Stereotactic Aspiration of Hematomas Using Urokinase. Journal of Cerebrovascular and Endovascular Neurosurgery 19(2): 81-91, 2017

Endoscope-assisted, minimally invasive evacuation of sub-acute/chronic epidural hematoma: Novelty or paradox of Theseus?. Acta Neurochirurgica 158(8): 1473-1478, 2017

Treatment of chronic subdural hematoma by minimally invasive drilling and drainage. Zhonghua Yi Xue Za Zhi 92(3): 203-205, 2013

Spontaneous spinal epidural hematoma management with minimally invasive surgery through tubular retractors: A case report and review of the literature. Medicine 95(26): E3906, 2017

Rapid Redistribution of an Acute Traumatic Epidural Hematoma in a Patient with Invasive Skull Cancer. Korean Journal of Neurotrauma 14(2): 138-141, 2018

Novel technique for the treatment of large subcapsular renal hematoma: combined use of percutaneous drainage and urokinase injection. International Urology and Nephrology 46(9): 1751-1755, 2015