METHOD FOR OPERATIVE HEMOSTASIS IN ACUTE HARDLY ACCESSIBLE EPIDURAL BLEEDINGS FROM DAMAGED VEINS, FRACTURES OF CRANIAL VAULT AND BASE AND SUBSEQUENT POSTOPERATIVE SUPERVISION Russian patent published in 2017 - IPC A61B17/34 A61M31/00 A61K31/417 A61P7/04 

FIELD: medicine.

SUBSTANCE: epidural hematoma is removed, then the dura mater is pierced and liquid is injected thereunder. At that, a puncture with an insulin needle is performed at an angle of approximately 30-40 degrees to the shell surface, its outer sheet is pierced, then the needle tip is slightly raised. The raised area is grasped with an anatomic tweezers and the insulin needle is further injected under the shell. Physiological solution containing 1-2 ml of cyanocobalamin is then injected into the subdural space in a volume sufficient to completely expand the dura mater and tightly adhere to the edges of the bone defect. Then the insulin needle is removed and an epidural catheter is installed through the hole in the dura mater, the height of the liquid column in which indicates the liquid level under the shell. When the shell stress on the catheter is relaxed, an additional volume of physiological solution containing cyanocobalamin is injected.

EFFECT: reduced frequency of hemorrhagic complications decreases, reduced operating injury of skull bones decreases, prevention of the development of the trepanized patients syndrome, minimized risk of hematoma recurrence and the best conditions for subsequent skull plasty are provided, while the hard shell is adapted to the edge of the bone defect.

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