{"id":"0a068f62-c513-4194-98f9-0509c5af4484","slug":"sni-17-442","title":"Large acute posttraumatic epidural hematoma centered beneath a cochlear implant: A case report","authors":["Moath A. J. Albhnasawi","Anwar S. S. Abualrous","Mohammed O. S. Abumustafa","Nidal M. M. Abuhadrous"],"abstract":"Background: Cochlear implants provide substantial functional benefit to patients with severe sensorineural hearing loss. Management of acute intracranial hemorrhage adjacent to a functioning cochlear implant presents a unique challenge, requiring a balance between urgent neurosurgical intervention and preservation of implant integrity and auditory function. Case Description: An 18-year-old male with congenital bilateral deafness and a right cochlear implant presented following a road traffic accident with severe headache and vomiting. Computed tomography demonstrated a large right parietotemporal acute epidural hematoma (EDH) centered directly beneath the cochlear implant receiver–stimulator. To minimize the risk of implant damage, a targeted burr-hole evacuation was performed two centimeters superior to the implant, using suction via a flexible nasogastric tube. Near-complete evacuation of the hematoma was achieved. Postoperatively, the patient made a full neurological recovery with preserved cochlear implant function. Conclusion: In selected cases of acute EDH adjacent to a functioning cochlear implant, a minimally invasive burr-hole approach may represent a safe and effective alternative to standard craniotomy, allowing hematoma evacuation while preserving implant function.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/sni-17-442/figures/SNI-17-442-g001.jpg","publishDate":"2026-08-07T00:00:00.000Z","doi":"10.25259/SNI_190_2026","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/0a068f62-c513-4194-98f9-0509c5af4484/pdf"}