Case Report: Stepwise quantitative assessment of intraoperative intracranial pressure after perforation, craniotomy, dural incision, and hematoma removal in acute subdural hematoma
By
Sota Wakahara
Ryota Tamura
Takahiro Iinuma
Konosuke Ishikawa
Kosuke Karatsu
Ryo Yamamoto
Yukio Sato
Junichi Sasaki
Masahiro Toda
June 23, 2026
Clinical Scorecard: Clinical Observation: Gradual Quantitative Evaluation of Intraoperative Intracranial Pressure Changes During Perforation, Craniotomy, Dural Incision, and Hematoma Evacuation in Acute Subdural Hematoma
At a Glance
Category Detail
Condition Acute Subdural Hematoma Key Mechanisms Surgical intervention to alleviate elevated intracranial pressure (ICP) Target Population Patients with severe traumatic brain injury (TBI) and acute subdural hematoma Care Setting Emergency departments and surgical units managing severe TBI
Key Highlights
Quantitative evaluation of ICP changes during surgical phases Significant reduction in ICP observed from each surgical intervention Mortality rate associated with delayed surgical decompression is high Emergency burr hole drainage may be effective in acute subdural hematoma Variability in institutional protocols for surgical intervention Guideline-Based Recommendations
Diagnosis
Utilize Glasgow Coma Scale and imaging for assessment of TBI Management
Prompt surgical decompression is critical within 2 hours of coma onset Monitoring & Follow-up
Continuous ICP monitoring is essential in severe TBI cases Risks
Increased mortality with delayed surgical intervention Patient & Prescribing Data
Male patient in his 40s with acute subdural hematoma
Initial conservative management followed by emergent decompressive craniectomy
Clinical Best Practices
Timely surgical intervention to reduce ICP Use of ICP monitoring to guide surgical decisions Consideration of emergency burr hole drainage in critical cases Related Resources & Content
