Intracranial hematoma surgery
Surgeries/Neurosurgery/Intracranial hematomas

Intracranial hematoma surgery

Surgical evacuation of intracranial bleeding, either as an emergency or as a scheduled procedure, to relieve compression of the brain.

What is it?

An intracranial hematoma is a collection of blood that forms inside the skull, following trauma, the rupture of a small vessel or, in elderly people, sometimes after a minor unnoticed impact (chronic subdural hematoma). By compressing the brain, it can cause headaches, confusion, weakness on one side of the body or impaired consciousness. Surgical treatment consists of evacuating the hematoma to relieve the compression. Depending on its nature and location, the neurosurgeon performs either a simple opening in the skull to drain the hematoma (a common technique for chronic subdural hematoma), or a wider opening (craniotomy) for acute hematomas. The speed of treatment is a decisive factor in the prognosis: this is why the clinic is organized to provide neurosurgical care without delay, from the emergency department to the operating room. At Clinique Pasteur Tunis, intracranial hematoma surgery benefits from a complete and responsive pathway: emergency department, CT scanner available at all times, operating room and a dedicated multipurpose intensive care unit, guaranteeing rapid and safe treatment at any hour.
Intracranial hematoma surgery

When is it indicated?

Symptomatic chronic subdural hematoma (headaches, confusion, weakness)

In elderly people, a pocket of blood can form slowly around the brain, sometimes after a minor forgotten impact. Draining it through a small opening quickly relieves the symptoms.

Acute extradural or subdural hematoma after head trauma

After significant head trauma, bleeding can rapidly compress the brain. Its emergency evacuation is then decisive.

Intracerebral hematoma accessible to surgery

Some bleeds located within the brain itself can be surgically evacuated when their position allows it and when doing so improves the prognosis.

Hematoma causing significant compression visible on CT scan

The CT scan guides the decision: when the hematoma clearly compresses the brain, the operation relieves this pressure and protects brain function.

Preparation

1Emergency brain CT scan to locate and measure the hematoma
2Coagulation work-up and correction of anticoagulant treatments
3Anesthesia consultation, adapted to the degree of urgency
4Pre-operative fasting when the degree of urgency allows

Procedure

1

General or local anesthesia depending on the type of hematoma

2

Burr hole or craniotomy depending on the nature of the hematoma

3

Evacuation of the blood and gentle washing of the cavity

4

Placement of a temporary drain if needed

5

Careful closure

6

Close monitoring in intensive care or in a step-down unit

7

Follow-up CT scan after the operation

Duration

30 minutes to 2 hours depending on the type of hematoma

Aftercare & Recovery

Symptoms often improve rapidly after evacuation, particularly for chronic hematomas. Any drain is removed after a few days, and a follow-up CT scan verifies proper progress. Recovery then continues gradually, with rehabilitation if necessary.

Risks and side effects

Possible recurrence of the hematoma, monitored by follow-up CT scans
Temporary confusion in elderly patients, resolving with recovery
Epileptic seizures, prevented by appropriate treatment if necessary

These risks remain rare. Your surgeon will inform you in detail before the procedure.

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At a glance

Duration: 30 minutes to 2 hours depending on the type of hematoma
Preparation: Required
Dedicated specialist team