Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 06 27 1476 1476 Tori Sepriwan Yukum Medical Centre Hospital, Anesthesiology and Intensive Therapy, Middle Lampung, Indonesia. & Dr. Hasan Sadikin Hospital, Anesthesiology and Intensive Therapy Subdivision, Neuroanesthesiology and Neuro Critical Care, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia. Dewi Bisri Department of Anesthesiology Faculty of Medicine, Universitas Padjadjaran – RS Padjajaran Bandung, Indonesia Radian Halimi Dr. Hasan Sadikin Hospital, Anesthesiology and Intensive Therapy Subdivision, Neuroanesthesiology and Neuro Critical Care, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia. 2025 11 06 2025 11 08 Subdural hematoma (SDH) is a blood clot between the dura mater and the arachnoid membrane surrounding the brain. Trauma is the leading cause of subdural hematoma. The perioperative management provided by the anesthetist for trauma brain injury is to prevent secondary injuries that occur and things that can be avoided, such as hypotension, hypoxemia, hyperglycemia, or hypercarbia. A 30-year-old man came with complaints of headaches after hitting a drainage canal. When the patient had a post-seizure, the patient was fully conscious. A CT-scan examination revealed subdural bleeding; the patient was diagnosed with subdural hematoma with epilepsy and a history of space-occupying lesions. The patient was planned to undergo a craniotomy. Management of TBI in the presence of a history of SOL is very complex and requires good perioperative management to prevent mortality and morbidity. This case report will explain the principles of neuroanesthesia used to prevent secondary brain injury with the facilities and infrastructure available at the hospital. https://aacc.tums.ac.ir/index.php/aacc/article/view/1476