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Is it necessary to drain out subdural hematoma through surgery?

Q: Recently my father fell down and injured his head. The CT scan of the head says that there is a subdural hematoma on his left convexity. The clot has not liquified yet and he is stable with no symptoms of worsening like drowsiness. He had a stroke few years ago and was partially paralysed to his right side. He manages to walk and use his right hand with little effort. Now his right side is totally paralysed and he cannot speak after this injury. The doctors say that he will have to undergo a minor surgery to put a burr hole in his head and drain out the liquid once it liquifies. Since this did not happen in a weeks time and the doctors say that it may take anywhere between 3 weeks to 3 months or more to liquify. What are the risks involved and success rate of the surgery? What will happen if the liquid is not drained out through surgery?

A:An operation is required if the clot is compressing the brain and causes consequent mental or physical handicap. A liquid subdural clot can be removed through one or more holes (termed burr holes) in the skull. These are usually made under local anaesthesia. Whilst the operation is safe in competent hands, there is a risk of recurrence of the clot. This may require further removal through the burr holes drilled at the first operation. If the liquid is not drained, there are two possibilities. The clot may increase in size and worsen the compression of the underlying brain. On the other hand, at times, the clot gradually may reduce in size and may even disappear.

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