Dr. Nene Devavrat Harihar
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 70 year old father had undergone left frontal and parietal, right frontal burr hole craniostomy with an evacuation of subdural hemorrhage under local anesthesia (LA) and sedation last month. Before the operation, his right side was not working and the problem was resolved after the operation and the doctor discharged him on the 1st of this month with the following medication at discharge: Tablet Levipil 500 mg: one tablet thrice daily to continue. Tablet Cetil 500 mg: one tablet twice daily for five days. Tablet PCM 1 g: one tablet thrice daily for five days. Tablet Pantocid 40 mg: one tablet daily before breakfast for 10 days. Tablet Amlodac 5 mg: one tablet once daily at 8 AM to continue. Tablet Shine 10 mg: one tablet once daily at bedtime for one month. Tablet Solitral: one tablet once daily at bedtime for three months. But, during the checkup (after CT scan study), the doctor advised a burr hole again as he mentioned in the prescription: Residual Chr. subdural hematoma (SDH) Bh FTP commonly, that is, mess effect'. Then the doctor again told me that he may need a third burr hole as well as the problem may sometimes happen. May I know is this due to diagnosis problem or something else? My concern is that it is difficult to go for the same operation again and again. Is there any solution for the hemorrhage problem. If I opted for the burr hole surgery at some good quality hospital with sophisticated facilities, will the problem will be solved completely? Is the recurrence of SDH due to a wrong diagnosis?
Hello,
Welcome to icliniq.com. The SDH (subdural hemorrhage) diagnosis usually does not go wrong. Since they have operated for the same, it is veryunlikely that there is any diagnostic dilemma. Chronic SDH recurrence is known to happen. And re-exploration needs to be done for the same. The cause of the recurrence needs to be evaluated with blood tests like PT (prothrombin time), aPTT (activated partial thromboplastin time), INR (international normalized ratio), and magnetic resonance imaging (MRI) brain with CISS (constructive interference in steady state) 3D protocol. This may give some diagnostic clue. If you are still in doubt, you can consult a neurosurgeon locally or on icliniq.
Patient's Query
Thank you doctor,
Is it possible to know the exact cause of recurrence and how to prevent it in the future?
Hello,
Welcome to icliniq.com. It is difficult to say. But, we can at least try.
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Neurology
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