A modified technique to treat, chronic and subacute subdural hematoma: Technical note

BACKGROUND, We present a patient on warfarin in whom a drainage port system was attached to the skull, successfully draining a subacute subdural hematoma. CASE DESCRIPTION An elderly male presented to our institution with right hemiparesis a week-following a motor vehicle accident. He was on warfarin for recurrent pulmonary emboli and suffered from severe coronary artery disease. Physical examination demonstrated a grade 3/5 hemiparesis and a computerized tomography (CT) scan confirmed the diagnosis of subacute subdural hematoma. He underwent twist drill craniostomy and attachment of the subdural evacuating port system. Recovery in this patient was dramatic. CONCLUSION The subdural evacuating port system (SEPS) permits the neurosurgeon to drain subacute or chronic hematomas by a method that is minimally invasive, simple, and safe. The SEPS appears to promote brain expansion without the potential biohazards of other standard techniques. (C) 2003 Elsevier Inc. All rights reserved.