Questions about Subdural Hematoma Evacuations

[sphericalchicken]

My colleague and I are participating in a course called The National Science Foundation's Innovation Corps (I-Corps) and are performing some background research on an unmet need in the field of subdural hematoma evacuations. We would really appreciate any insight on any one or more of these questions:


When you were performing your last subdural hematoma evacuation, what was the biggest challenge you faced?
How long did your last procedure take?
When you have an older patient, what is your thought process when deciding what is the best way to enter (craniotomy/burr hole/other)?What are your thoughts on a surgery that is faster but less effective at preventing SDH recurrences vs. slower but more effective at preventing recurrences?


Thank you for your time and help!

[Guest]

(10-08-2021, 11:28 PM)My sphericalchicken Wrote: My colleague and I are participating in a course called The National Science Foundation's Innovation Corps (I-Corps) and are performing some background research on an unmet need in the field of subdural hematoma evacuations. We would really appreciate any insight on any one or more of these questions:


When you were performing your last subdural hematoma evacuation, what was the biggest challenge you faced?
How long did your last procedure take?
When you have an older patient, what is your thought process when deciding what is the best way to enter (craniotomy/burr hole/other)?What are your thoughts on a surgery that is faster but less effective at preventing SDH recurrences vs. slower but more effective at preventing recurrences?


Thank you for your time and help!

1) no challenges, short of battery change one of easiest cases in our field

2) <30 min.. anesthesia setup takes much longer than actual case

3) don’t decide by age of patient, but age of bleed:
Subacute/chronic - motor oil consistency, typically burr hole or SEPS
Acute - clotted typically and more often require crani 

4) 
Surgery speed will not really determine recurrence.. maybe extent of evacuation but recurrence is typically due to whatever medical dilemma/medication regimen +/- trauma that caused it in first place.

What exactly is the unmet need? The problem stems from medical mismanagement of ASA/AC therapy, but sometimes just can’t be prevented.