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Is Surgery Required For Midline Shift After Subdural Haematoma Surgery?

Posted on Sat, 3 May 2014

Question: If a person has gone thru subdural haematoma surgery and doesnt come out of coma state and CT scans start showing a midline shift,does he need a re operation?

Answered by Dr. Praveen K Nath (9 minutes later)

you are correct that this could indicate that the patient may need further surgery.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Praveen K Nath (9 days later)

How soon should the surgery be undertaken? is it a situation where immediate surgery is a must?

Answered by Dr. Praveen K Nath (39 minutes later)

Brief Answer: subdural hematoma - recurrence needs evaluation Detailed Answer: Hello, In case of a Post-operative patient who is still unconscious & CT HEAD is showing mid-line shift I would suggest to: 1. Get a MRI brain to rule out any underlying brain damage /infarct & to see whether mid-line shift is due to re-bleed or due to cerebral edema. 2 If re-bleed,then it may /may not need surgery, depending on size of bleed. 3 If there is no re-bleed , & mid-line shift is due to edema or underlying brain damage, then conservative treatment with medications /ventilation is required. 4 Medications like mannitol / frusemide & hyperventilation is helpful in these cases Hope this answers your query. Wishing a speedy recovery. Thanx Dr XXXXXXX k XXXXXXX Director Deptt. of neurosurgery

Above answer was peer-reviewed by : Dr. Shanthi.E