{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T01:22:44Z","timestamp":1725412964821},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:p>An acute subdural hematoma (SDH) requiring surgical intervention is treated with craniotomy or craniectomy, in part because it is generally accepted that coagulated blood present in the acute phase cannot be adequately evacuated by less-invasive means such as bur hole drainage. However, a hyperacute SDH in the first few hours after trauma can have mixed-density components on CT scans that are thought to represent subdural blood that is not yet fully coagulated.<\/jats:p>\n<jats:p>The authors report a case in which a hyperacute SDH in a patient receiving antiplatelet therapy was treated with the novel technique of temporizing subdural evacuation port system (SEPS) placement. Placement of an SEPS in the intensive care unit allowed for rapid surgical treatment of the patient's elevated intracranial pressure (ICP) by drainage of 70 ml of fresh subdural blood. After initial SEPS-induced stabilization, the patient underwent operative treatment of the SDH by craniotomy. The combined approach of emergency SEPS placement followed by craniotomy resulted in a dramatic recovery, with improvement from coma and extensor posturing to a normal status on neurological evaluation 5 weeks later. In appropriately selected cases, patients with a hyperacute SDH may benefit from SEPS placement to quickly treat elevated ICP, as a bridge to definitive surgical treatment by craniotomy.<\/jats:p>","DOI":"10.3171\/2011.5.jns1123","type":"journal-article","created":{"date-parts":[[2011,6,18]],"date-time":"2011-06-18T02:30:47Z","timestamp":1308364247000},"page":"844-848","source":"Crossref","is-referenced-by-count":4,"title":["Temporizing treatment of hyperacute subdural hemorrhage by subdural evacuation port system placement"],"prefix":"10.3171","volume":"115","author":[{"given":"Alexander C.","family":"Flint","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kaiser Permanente, Redwood City; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alisa D.","family":"Gean","sequence":"additional","affiliation":[{"name":"Departments of Radiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey T.","family":"Manley","sequence":"additional","affiliation":[{"name":"Neurosurgery (Brain and Spinal Injury Center), University of California, San Francisco, San Francisco General Hospital, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek A.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kaiser Permanente, Redwood City; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William F.","family":"Sheridan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kaiser Permanente, Redwood City; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia S.","family":"von Koch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kaiser Permanente, Redwood City; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns1123","series-title":"Radiology","first-page":"433","article-title":"The swirl sign","volume":"218","author":"Al-Nakshabandi","year":"2001"},{"key":"b2-jns1123","series-title":"Radiology","first-page":"874","article-title":"Acute and subacute intracerebral hemorrhages: comparison of MR imaging at 1.5 and 3.0 T\u2014initial experience","volume":"232","author":"Allkemper","year":"2004"},{"key":"b3-jns1123","series-title":"Acta Neurochir (Wien)","first-page":"193","article-title":"Hyperacute epidural haematoma isodense with the brain on computed tomography","volume":"146","author":"Arrese","year":"2004"},{"key":"b4-jns1123","series-title":"Pediatr Radiol","first-page":"74","article-title":"CT findings in hyperacute nonaccidental brain injury","volume":"30","author":"Barnes","year":"2000"},{"key":"b5-jns1123","series-title":"Stroke","first-page":"2025","article-title":"Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage","volume":"30","author":"Becker","year":"1999"},{"key":"b6-jns1123","series-title":"Radiology","first-page":"15","article-title":"MR appearance of hemorrhage in the brain","volume":"189","author":"Bradley","year":"1993"},{"issue":"Suppl 1","key":"b7-jns1123","series-title":"J Neurotrauma","first-page":"7","article-title":"Guidelines for the management of severe traumatic brain injury. 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