Aneurysmal subarachnoid hemorrhage and acute subdural hematoma, neurosurgical and endovascular rescue. Case report.

Authors

José Omar Santellan Resident, Petróleos MexicanosFollow
José Ramón Aguilar Dr., Petróleos MexicanosFollow
Abraham Ibarra Dr., Petróleos MexicanosFollow
Ulises García Dr., Petróleos MexicanosFollow

Corresponding Author

Corresponding author:

José Omar Santellán Hernández^. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad, PEMEX, Periférico sur 4091, Fuentes del Pedregal, 14140, Periférico Sur 4091, Fuentes del Pedregal, Tlalpan, 14140, Mexico City, Mexico. Email: omarsantellan@gmail.com.

Document Type

Case Report

Abstract

Introduction: Acute subdural hemorrhage (aSDH) in association with aneurismal subarachnoid hemorrhage (SAH) is a severe disease with an incidence of 0.5% to 7.9% of all SAH. Due to the rarity of aneurysmal aSDH, it remains difficult to define a comprehensive management protocol. In this case review, following the CARE guidelines, we show the hybrid management of this pathology to know the importance of using different types of neurosurgical treatments in case of two severe diseases in critical patients.

We present two patients who developed sudden onset cephalea and neurological impairment secondary to aneurysmal subarachnoid hemorrhage associated with acute subdural hematoma. These cases required emergency decompressive craniectomy and aneurysm embolization with coils that have a favorable outcome.

In patients with massive and rapidly fatal subdural hemorrhage, emergency craniotomy with hematoma evacuation and immediate brain decompression before definitive aneurysm surgery has shown to be a good treatment option with excellent survival outcomes.

Conclusion: Endovascular obliteration following a surgical procedure for evacuation of aSDH remains a reliable option to avoid any additional procedures that could result in an increased risk of morbidity in a critically ill patient with aneurysmal aSDH and SAH.

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Recommended Citation

Santellan, José Omar Resident; Aguilar, José Ramón Dr.; Ibarra, Abraham Dr.; and García, Ulises Dr. (2022) "Aneurysmal subarachnoid hemorrhage and acute subdural hematoma, neurosurgical and endovascular rescue. Case report.," Archives of Neurosurgery: Vol. 1: Iss. 2, Article 3.
Available at: https://www.ansjournal.org/home/vol1/iss2/3