English CENTRAL DURAL TENTING SUTURES IN A PATIENT WITH TRAUMATIC ACUTE EPIDURAL HEMATOMA: A CASE REPORT

  • Aleksandar Marković Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Jovan Ilić Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Ivan Stefanović Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Vesna Nikolov Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Miša Radisavljević Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Jelena Kovačević Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Nikola Stojanović Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia
  • Marija Djordjević Faculty of Medicine, University of Niš
Keywords: epidural hematoma, dural tenting suture

Abstract


It is of paramount significance to diagnose epidural hematoma (EDH) as soon as possible and to evacuate EDH if necessary. Our aim was to show the importance of placing prophylactic central dural tenting sutures (DTS) for ensuring adequate hemostasis. We present a case of a 62-year-old male patient, who was diagnosed with an acute traumatic EDH and cerebral hemorrhagic contusion. The postoperative course was complicated by deterioration of the patient's consciousness and worsening of the left-sided hemiparesis, therefore we performed a head CT scan, which showed the formation of the new EDH at the operating site. Moreover, we reoperated the patient with the placement of multiple central DTS, while the control head CT scan showed a complete evacuation of the EDH. Consequently, the patient made a good recovery at discharge, with a remaining discrete left-sided hemiparesis. Prophylactic central DTS are important for maintaining an adequate hemostasis while operating on patients with EDH.

Author Biographies

Ivan Stefanović, Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia

1Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia

2Faculty of Medicine, University of Niš, Niš, Serbia

Vesna Nikolov, Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia

1Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia

2Faculty of Medicine, University of Niš, Niš, Serbia

Miša Radisavljević, Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia

1Department of Neurosurgery, University Clinical Center of Niš, Niš, Serbia

2Faculty of Medicine, University of Niš, Niš, Serbia

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Bonow RH, Barber J, Temkin NR, Videtta W, Rondina C, Petroni G, et al. Global Neurotrauma Research Group. The Outcome of Severe Traumatic Brain Injury in Latin America. World Neurosurg 2018; 111: e82-e90. [CrossRef] [PubMed]

Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, et al. Surgical management of acute subdural hematomas. Neurosurgery 2006; 58(Suppl 3): S2-16. [CrossRef] [PubMed

Chicote AE, González CA, Ortiz LM, Jiménez AA, Escudero AP, Rodríguez BJC, et al. Epidemiology of traumatic brain injury in the elderly over a 25 year period. Rev Esp Anestesiol Reanim 2018; 65(10): 546-51. [CrossRef] [PubMed]

Chivukula S, Weiner GM, Engh JA. The early days of hemostasis in neurosurgery. Neurosurg Focus 2014; 36(4): E5. [CrossRef] [PubMed]

Eroglu U, Zaimoğlu M, Sayacı EY, Ugur HC, Attar A, Kahilogullari G, et al. Is Placing Prophylactic Dural Tenting Sutures a Dogma? World Neurosurg 2021; 153: e403-7. [CrossRef] [PubMed]

Katsuhara T, Otani N, Yamamuro S, Kajimoto R, Kobayashi M, Hirayama K, et al. Novel threading device for central dural tenting sutures. Interdiscip Neurosurg 2021; 25: 101199. [CrossRef]

Khairat A, Waseem M. Epidural hematoma. StatPearls (serial online) 2021 Aug “cited 2022 Nov 30”. [PubMed]

Kostić A, Veselinović A, Nikolov V, Stefanović I, Mitić R, Radisavljević M, et al. A combination of acute and delayed contralateral epidural hematoma. Srp Arh Celok Lek 2018; 146(3-4): 193-6. [CrossRef]

Nishiyama Y, Kanemaru K, Yoshioka H, Hanihara M, Horikoshi T, Kniouchi H. Intracranial pial arteriovenous fistula caused by dural tenting: case report. Neurol Med Chir 2014; 54(3): 242-4. [CrossRef] [PubMed]

Park J. Self-drilling anchor screws for dural tenting sutures. Surg Neurol 2009; 72(2): 175-6. [CrossRef] [PubMed]

Paulo D, Semonche A, Choudhry O, Al-Mufti F, Prestigiacomo CJ, Roychowdhury S, et al. History of hemostasis in neurosurgery. World Neurosurg 2019; 124: 237-50. [CrossRef] [PubMed]

Slavko Živković, Jovan Ilić, Vesna Nikolov, Vesna Stokanović, Radisav Mitić, Marija Djordjević, et al. A case report on traumatic delayed epidural hematoma with atypical presentation. Acta Med Median 2022; 61(2): 60-71. [CrossRef]

Wadanamby S, Dharmapala HH, Ranaweera C, Packeer MS, Wadanamby SU. Is dural hitching necessary to prevent post-operative extradural haemorrhage in craniotomies and craniectomies. Sri Lanka J Surg 2016; 34(2): 7-11. [CrossRef]

Published
2023/06/16
Section
Case report