Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Dec 31:43:100750.
doi: 10.1016/j.tcr.2022.100750. eCollection 2023 Feb.

Drainage of an extradural haematoma by intraosseous needle in a remote hospital

Aruni Sen  1 , Nemer Kharroubi  1 , Anthea Pinder  1 , Jonathan Hempenstall  2
Affiliations
Case Reports

Drainage of an extradural haematoma by intraosseous needle in a remote hospital

Aruni Sen et al. Trauma Case Rep. .

Abstract

We report the case of an intraosseous needle used to drain an acute extra-dural haematoma in a remote hospital. An 18 yr. old female attended the Emergency Department, after sustaining a closed head injury from a fall. After a CT scan, she was diagnosed with a large acute extradural haematoma (EDH). Prior to air ambulance transfer to the Neurosurgical Centre, she developed a fixed dilated pupil and hemodynamic instability. The Neurosurgeon advised that an intraosseous (IO) needle drainage would prevent brain stem herniation. An Emergency Medicine (EM) consultant drained 60 ml of blood and clot via an IO needle. The pupil and cardiovascular status normalised. The patient underwent neurosurgical drainage with full neurological recovery. We believe that this is the first IO drainage of an EDH at a remote hospital followed by full neurological recovery.

Keywords: Acute extradural haematoma; Intraosseous needle drainage; Remote medicine; Traumatic brain injury.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Image 1
Image 1
CT scan showing large EDH and intracranial air.
Picture 1
Picture 1
IO needle in situ on left temporal bone.
See this image and copyright information in PMC

References

    1. National Institute of Clinical Excellence . Vol. 176. 2019. Head Injury – Assessment & Early Management. CG.
    1. Bulstrode H., Kabwama S., Durnford A., et al. Temporising extradural haematoma by craniostomy using an intraosseous needle. Injury. 2017;48:1098–1100. - PubMed
    1. McClung C., Anshus J., Anshus A., et al. Bedside craniostomy and serial aspiration with an intraosseous drill/needle to temporize an acute epidural haemorrhage with mass effect. World Neurosurg. 2020;142:218–221. - PubMed
    1. Durnford S., Bulstrode H., Durnford A., et al. Temporising an extradural haematoma by intraosseous needle craniostomy in the district general hospital by non-neurosurgical doctors – a case report. JICS. 2018;19:76–79. - PMC - PubMed
    1. Howard A., Krishnan V., Lane G., et al. Cranial Burr holes in the emergency department: to drill or not to drill. EMJ. 2020;37:151–153. - PubMed

Publication types

LinkOut - more resources