Even Minor Head Injuries Require Attention
Early Treatment to Remove Hematomas

Chronic subdural hematoma, which can develop even from a minor head injury, is treated promptly and safely with hematoma removal surgery under local anesthesia. Early detection and treatment aim to improve symptoms.

Providing Medical Institution

Kishiwada Tokushukai Hospital

〒596-0042
4-27-1 Kamoricho, Kishiwada City

https://kishiwada.tokushukai.or.jp/en/

Specialty

**Cardiovascular Surgery:**
1. Coronary Artery Disease
2. Heart Valve Disease
3. Aortic Aneurysm
4. Aortic Dissection
5. Arteriosclerosis Obliterans
6. Arterial Thrombosis
7. Complications of Myocardial Infarction
- Ischemic Cardiomyopathy
- Left Ventricular Rupture
- Left Ventricular Aneurysm
- Ventricular Septal Rupture
- Papillary Muscle Dysfunction (Mitral Regurgitation)
8. Infective Endocarditis
9. Intracardiac Tumors

**Cardiology:**
1. Ischemic Heart Disease (e.g., Angina, Myocardial Infarction)
2. Lower Limb Arteriosclerosis Obliterans
3. Arrhythmia
4. Heart Valve Disease
5. Aortic Stenosis
6. Mitral Regurgitation

**Lower Gastrointestinal Surgery**
*Da Vinci Si - Robot-Assisted Surgery*
1. Malignant Diseases
2. Surgical Treatment of Small and Large Intestine Diseases
3. Primarily Surgical and Medical Treatments for Colon and Rectal Cancer
4. Robot-Assisted Surgery
5. Laparoscopic Surgery
6. Multimodal Therapy Combining Surgery, Chemotherapy, and Radiation Therapy
7. Systemic Chemotherapy for Unresectable Colorectal Cancer

**Breast Surgery:**
1. Breast-Conserving Surgery
2. Mastectomy
3. Sentinel Lymph Node Biopsy
4. Lymph Node Dissection
5. Breast Reconstruction Using Autologous Tissue

**Neurosurgery:**
1. Stroke
2. Cerebral Hemorrhage
3. Subarachnoid Hemorrhage
4. Cerebral Infarction
5. Head Trauma
6. Traumatic Intracranial Hematoma
7. Skull Fracture
8. Chronic Subdural Hematoma
9. Brain and Spinal Cord Tumors
10. Acoustic Neuroma
11. Pituitary Tumor
12. Meningioma
13. Metastatic Brain Tumors
14. Functional Neurological Disorders
15. Facial Spasm
16. Trigeminal Neuralgia
17. Epilepsy
18. Normal Pressure Hydrocephalus

**Urology**
*Da Vinci Si - Robot-Assisted Surgery*
1. Robot-Assisted Laparoscopic Radical Prostatectomy
2. Prostate Cancer
3. Renal Cancer
4. Upper Urinary Tract Cancer
5. Urolithiasis (Urinary Stones)

**Radiology:**
1. Comprehensive Imaging Diagnosis (X-ray, Ultrasound, CT, MRI, Angiography, PET)
2. Liver Tumors
3. Gastrointestinal Hemorrhage
4. Arterial Embolization for Hemoptysis and Traumatic Hemorrhage
5. Transcatheter Venous Embolization for Gastric Varices
6. Intra-Arterial Chemotherapy for Cancer
7. Reservoir Placement
8. CT-Guided Biopsy (Interventional Radiology - IVR)
9. TomoTherapy - Radixact

**Dialysis**
*Travel Hemodialysis* (Available for Individual Travelers Only, Not for Groups)

**Other**
*Second Opinion* (In-person Only, Online Not Available)

Eligibility Criteria/Exclusions for Treatment

Eligibility Criteria 1. Medical Information: Diagnosis (e.g., chronic subdural hematoma) Detailed symptoms (e.g., headache, hemiparesis, cognitive decline, loss of motivation) Examination results from other institutions (confirmation of hematoma via CT or MRI) Presence of comorbidities (e.g., diabetes, hypertension, heart disease) 2. History of Treatment: History of head trauma, surgeries, or neurosurgical treatments Current medications (e.g., antiplatelet agents, anticoagulants) Presence of allergies or adverse drug reactions 3. Age and Physical Fitness: Assessment of whether elderly patients or those with comorbidities can tolerate surgery or anesthesia Evaluation of suitability for surgery under local anesthesia 4. Severity and Urgency of Symptoms: Degree of symptoms caused by the hematoma (e.g., headache, hemiparesis, or disorientation) Confirmation of hematoma size and degree of compression via CT or MRI 5. Other Conditions: Ability to manage blood pressure and antiplatelet medication usage Willingness and ability to cooperate with postoperative hospitalization and followup care

Precautions / Contraindications

【Precautions and Contraindications】

1. Cases Not Suitable for Treatment:
Patients with severe comorbidities (e.g., heart disease, untreated infections, renal failure) may face high surgical or anesthesia risks, limiting treatment options.
Patients unable to discontinue antiplatelet or anticoagulant medications may have an elevated bleeding risk, restricting treatment options.

2. Risk of Hematoma Recurrence:
About 10% of patients may experience hematoma recurrence after surgery, necessitating an understanding of the possibility of reoperation.
Patients requiring longterm anticoagulant use are at higher risk of recurrence.

3. Postoperative Complication Risks:
Surgery carries risks of infection, bleeding, and hematoma recurrence, with careful postoperative management particularly essential for elderly patients.
Rapid relief of brain compression may cause temporary postoperative headaches or dizziness.



# 【Important PreTreatment Information】

1. Preoperative Preparation:
Follow medical instructions for discontinuation of antiplatelet or anticoagulant medications to mitigate bleeding risks.
Preoperative CT or MRI scans are critical for assessing the condition of the hematoma and determining surgical eligibility.

2. Postoperative Care and FollowUp:
Infection prevention and bleeding management are essential after surgery. Contact a medical institution promptly if headaches, dizziness, or signs of infection occur.
A hospital stay of about one week is typically required, followed by regular outpatient followup.

3. Lifestyle and Daily Precautions:
Protect the head from strong impacts after discharge.
Manage blood pressure and adopt lifestyle improvements, such as avoiding alcohol and smoking.

4. Regular FollowUp:
Regular CT or MRI followups are necessary to monitor hematoma and intracranial pressure postsurgery.
Attend scheduled outpatient visits and promptly report any abnormalities to the physician.

5. Emergency Response:
Contact a medical institution immediately if symptoms such as hemiparesis, headache, altered consciousness, or gait disturbances recur after discharge.
Confirm emergency contact information for accessible medical institutions and attending physicians in advance.