Chronic Subdural Heatom A Case Study

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The decision to perform surgical treatment to evacuate a chronic subdural hematoma was guided by the clinical presentation of the patient and the radiographic appearance of the lesion (Soleman, Taussky, Fandino, & Muroi, 2014). The patient’s CT scan revealed a hypodense chronic subdural hematoma with a midline shift. She was prepared for immediate surgical evacuation. The three surgical options for chronic SDH include percutaneous twist-drill craniostomy (TDC), operative burr-hole evacuation (BHC), and craniotomy. The neurosurgeon and the patient’s son agreed on TDC; the son signed the informed consent. The patient was placed on continuous electrocardiograph (ECG) and pulse oximetry. In regards to emergency surgery and patients who are on antiplatelet medications such as clopidogrel and aspirin, the American Society of Hematology (2011), recommends pre-operative platelet transfusion. An indwelling urinary catheter was inserted and mannitol 74 g (1g/kg) was given IV push (Meagher & Young, 2015) per physician’s
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The patient should understand the importance of follow-up appointments with the surgeon where neuroimaging is performed and early recognition of any complications addressed. The patient should be efficacious in scheduling her home therapy with the rehabilitation team including: physical therapy to help with movement and weakness, language therapist, and an occupational therapist to help activities of daily living. The most effective determent of SDH is the prevention of falls and head injuries. Interventions to reduce falls in older adults include: implementing exercise program to improve strength and balance, medication review to verify none are causing dizziness, regular eye exams, and home safety assessment to reduce hazards and improve lighting (Centers for Disease Control and Prevention [CDC],

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