{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:37:15Z","timestamp":1775842635695,"version":"3.50.1"},"reference-count":25,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nThe big black brain (BBB) phenomenon is described as an infant\u2019s response to an acute subdural hematoma (SDH). It is characterized by hypodensity and swelling of the supratentorial compartment as a whole. Numerous factors may contribute to the formation of the BBB. Due to its high morbidity and mortality, the management of BBB is still debatable. In this report, we describe a 2-month-old boy who had bilateral hemispheric hypodensity and underwent hinge craniotomy.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nThe patient was referred to our hospital with decreased consciousness. The patient had a history of seizures and cardiopulmonary arrest. There is no history of trauma. The computed tomography revealed a subacute SDH on the left parietal and occipital lobe along with hypodensity in both hemispheres with preservation of posterior fossa, consistent with hemispheric hypodensity. We performed a hinge craniotomy for the emergency procedure and evacuated only the hemisphere with the bleeding side. The patient cried spontaneously 24 hours after the procedure and was discharged six days later.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nEarly outcomes of hinge craniotomy as an alternative procedure for treating the BBB were positive. However, long-term outcomes, particularly the infant\u2019s development, should be monitored.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_715_2023","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T11:22:32Z","timestamp":1702639352000},"page":"427","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Managing the \u201cbig black brain\u201d in low resource setting: A case report of early outcome after hinge craniotomy"],"prefix":"10.25259","volume":"14","author":[{"given":"Andre Marolop Pangihutan","family":"Siahaan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahagia Willibrordus Maria","family":"Nainggolan","sequence":"additional","affiliation":[{"name":"School of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Susanto","sequence":"additional","affiliation":[{"name":"School of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rr Suzy","family":"Indharty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Tandean","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"10.25259\/SNI_715_2023\/ref-1","first-page":"e8011","article-title":"Big black brain phenomenon: Understanding clinicoradiological dissociation in non-accidental traumatic brain injury in children","volume":"12","author":"Beriwal","year":"2020","journal-title":"Cureus"},{"key":"10.25259\/SNI_715_2023\/ref-2","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1089\/neu.2018.5736","article-title":"Development of a model of hemispheric hypodensity (\u201cBig Black Brain\u201d)","volume":"36","author":"Costine-Bartell","year":"2019","journal-title":"J Neurotrauma"},{"key":"10.25259\/SNI_715_2023\/ref-3","first-page":"513","article-title":"The shaken baby syndrome: Diagnosis using CT and MRI","volume":"67","author":"Cox","year":"1996","journal-title":"Radiol Technol"},{"key":"10.25259\/SNI_715_2023\/ref-4","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.3171\/2017.11.JNS171500","article-title":"Global neurosurgery: The current capacity and deficit in the provision of essential neurosurgical care. 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