Emergency Decompression Craniotomy in the Emergency Room for Severe Subdural Hematomas by Traffic Accidents

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  • HIRAIZUMI Shiho
    Department of Emergency and Critical Care Medicine Saiseikai Shiga Hospital
  • Kato Fumitaka
    Department of Emergency and Critical Care Medicine Saiseikai Shiga Hospital
  • NOZAWA Masahiro
    Department of Emergency and Critical Care Medicine Saiseikai Shiga Hospital
  • ECHIGO Tadashi
    Department of Emergency and Critical Care Medicine Saiseikai Shiga Hospital
  • SHIOMI Naoto
    Department of Emergency and Critical Care Medicine Saiseikai Shiga Hospital

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Other Title
  • 交通事故に起因する重症急性硬膜下血腫に対する初療室減圧開頭術
  • コウツウ ジコ ニ キイン スル ジュウショウ キュウセイコウマク カケッシュ ニ タイスル ハツリョウシツゲンアツカイトウジュツ

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Mortality of severe acute subdural hematoma is very high, therefore decompression craniotomy as soon as possible is recommended. We examined the cases of severe acute subdural hematoma by traffic accidents, operated in emergency room, about the time coarse, outcome and efficacy. Between April 2011 and December 2016, we operated 7 patients of severe acute subdural hematoma in emergency room, and traffic cases were 6. We examine duration of onset to arrival to hospital, duration of arrival to diagnosis by computed tomography and duration of diagnosis to operation, and outcome on discharge. Mean duration of onset to arrival to hospital is 38.8 minutes, mean duration of arrival to diagnosis is 25.2 minutes, and mean duration of diagnosis to operation is 25.8 minutes. On discharge, the results were 3 good outcomes（GR 1, MD 2; 50.0％）, and death is 1（16.7％）. Decompression craniotomy in emergency room is able to be started within 30 minutes, therefore there is a possibility that it improves the outcomes of severe acute subdural hematoma.

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