Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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01-DECEMBER-2013 BASSAM SULAYMAN AL-SABBER 65
YEARS RECURRENT CHRONIC SUBDURAL HEMATOMA RIGHT CONVEXITY.
The patient was operated by me
11-November-2013 for huge chronic subdural
hematoma right cerebral convexity and check MRI
done after surgery was acceptable. The patient
then came to the clinic 30-November-2013 for
check up with new MRI done this day with the
hematoma reaccumulated. He was neurologically
free, but he was complaining of fatigue and mild
Using the burr holes in the
right frontal and most posterior aspect of the
right parietal region, craniotomy was done with
reflection of the bone flap to the right ear.
The dura was opened in inverted U-shaped
fashion. The thick membranous hematoma was seen
and dissected off the dura and evacuated. The
external layer of the capsule was removed. The
internal layer of the hematoma was identified
and resected with strict preservation of the
cortex and running arteries and veins. Strict
heamostasis and water-tight closure of the dura.
Routine closure of the wound with ready-vac
drain under the skin.
recovery. The patient was sent to the ICU for
During 35 years, most of the chronic subdural
hematomas were treated successfully by the
external drain. The last four cases required
craniotomy after failed burr hole surgery,
including this last case. This could be
coincidental, but special investigations must be
made to know the cause of such phenomenon.
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