Identification of chronic subdural hematoma types most responsive to Goreisan, Kampo medicine: A retrospective study

2020 ◽  
Vol 78 ◽  
pp. 198-202
Author(s):  
Yoshinao Harada ◽  
Kensaku Yoshida ◽  
Shuko Nojiri ◽  
Yumiko Kurihara ◽  
Hiroyuki Kobayashi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Kampo Medicine

scholarly journals Snowfall reduces the risk of chronic subdural hematoma onset: Analysis of an administrative database in Japan

2021 ◽  
Vol 12 ◽  
pp. 69
Author(s):  
Kazunori Oda ◽  
Shotaro Aso ◽  
Yujiro Hattori ◽  
Fumio Yamaguchi ◽  
Hiroki Matsui ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Subdural Hematoma ◽  
Odds Ratio ◽  
Chronic Subdural Hematoma ◽  
Japan Meteorological Agency ◽  
Administrative Database ◽  
Diagnosis Procedure Combination ◽  
Binomial Approximation ◽  
The Relationship ◽  
Inpatient Database

Background: Chronic subdural hematoma (CSDH) is a frequently observed disease in neurosurgical practice. Although first snowfall has been considered to increase the onset of CSDH, few reports have assessed the relationship between snowfall and CSDH. In this study, we aimed to investigate the relationship between CSDH onset and first snowfall events. Methods: This retrospective study was based on the Japanese Diagnosis Procedure Combination inpatient database from July 1, 2010, to March 31, 2016, and on the global observation of snowfall events in Japan obtained from the Japan Meteorological Agency. We used a binomial approximation to evaluate the average number of CSDH patients after first snowfall events compared with that before first snowfall events. We calculated the odds ratio of CSDH onset on the first snowfall. Results: We identified 8526 CSDH patients from the database. A total of 5573 (65.4%) were observed before first snowfall events, and 2953 (34.6%) after first snowfall events. The first snowfall of winter was significantly associated with a reduction in the occurrence of CSDH (odds ratio, 0.53; 95% confidence interval; 0.51–0.55). In subgroup analysis, only the first snowfall in October was not associated with reduction in the occurrence of CSDH. Conclusion: First snowfall events did not affect the onset of CSDH in Japan.

Cranial reconstruction using a polycaprolactone implant after burr hole trephination

2020 ◽  
Vol 4 (1) ◽  
pp. 9-16
Author(s):  
Ning Chou
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Tissue Regeneration ◽  
Subdural Hematoma ◽  
Surgical Complications ◽  
Chronic Subdural Hematoma ◽  
Burr Hole ◽  
Tumor Biopsy ◽  
Soft Tissue Regeneration

Aim: This retrospective study evaluated the safety of using polycaprolactone (PCL) burr hole covers over a 10-year period. Materials & methods: Patients with PCL burr hole cover implants inserted between 1 April 2006 and 31 September 2015 were identified and included in this study. Burr hole covers were used in surgery for chronic subdural hematoma, hydrocephalus and tumor biopsy. Results: 174 patients with a total of 275 implants inserted were included in the study. Overall, the use of PCL implants was safe and did not increase the rate of surgical complications. The radiology study of two cases and histology study of a removed PCL implant demonstrated evidence of soft tissue regeneration. Conclusion: PCL burr hole covers demonstrated safety in use for craniotomy burr hole reconstruction.

scholarly journals Effect of Japanese Herbal Kampo Medicine Goreisan on Reoperation Rates after Burr-Hole Surgery for Chronic Subdural Hematoma: Analysis of a National Inpatient Database

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hideo Yasunaga
Keyword(s):  
Subdural Hematoma ◽  
Propensity Scores ◽  
Experimental Studies ◽  
Chronic Subdural Hematoma ◽  
Reoperation Rate ◽  
Burr Hole ◽  
Kampo Medicine ◽  
Antithrombotic Agent ◽  
Reoperation Rates ◽  
Inpatient Database

Goreisan is a herbal Kampo medicine used for treating chronic subdural hematoma (CSDH) in Japan. Experimental studies have suggested that Goreisan exerts a hydrogogue effect, but clinical evidence for the effectiveness of Goreisan in CSDH is currently lacking. Using a national Japanese inpatient database, we examined the association between Goreisan use and reoperation rates after burr-hole surgery for CSDH. We identified 36,020 patients, including 3,889 Goreisan users and 32,131 nonusers. Propensity scores of receiving Goreisan were calculated based on hospital characteristics and patient backgrounds (age, sex, body mass index, activities of daily living, consciousness level, comorbidities, antithrombotic agent use, mannitol infusion, and corticosteroid infusion). One-to-one propensity-score matching created 3,879 pairs of Goreisan users and nonusers. Propensity-matched analysis revealed that Goreisan use was significantly associated with a lower reoperation rate (4.8%) compared with nonuse (6.2%) (risk difference, −1.4%; 95% confidence interval (CI), −2.4% to −0.38%). The number needed to prevent one reoperation was 72 (95% CI, 41–265). Instrumental-variable analysis showed similar results to the propensity-matched analysis. These results suggest that Goreisan use reduced the need for reoperation after burr-hole surgery for CSDH.

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