scholarly journals Endovascular therapy for the management of chronic subdural hematomas after failure of surgical drainage

2021 ◽  
Author(s):  
R. Martinez-Perez ◽  
N. Rayo ◽  
A. Tsimpas
Keyword(s):  
Endovascular Therapy ◽  
Surgical Drainage ◽  
Subdural Hematomas

scholarly journals The Value of Programmable Shunt Valves for the Management of Subdural Collections in Patients with Hydrocephalus

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitrios Pachatouridis ◽  
George A. Alexiou ◽  
Evaggelos Mihos ◽  
George Fotakopoulos ◽  
Spyridon Voulgaris
Keyword(s):  
Fluid Collection ◽  
Adult Patients ◽  
Subdural Fluid Collection ◽  
Surgical Drainage ◽  
Opening Pressure ◽  
Related Complication ◽  
Pressure Setting ◽  
Subdural Hematomas

Background. The aim of the present study was to assess the value of electromagnetic programmable shunt valves for the treatment of subdural collections.Methods. Adult patients with hydrocephalus of various causes that were treated with programmable shunt valves during the last ten years were retrospectively studied. In 127 patients, 139 electromagnetic programmable shunt valves were implanted.Results. A nontraumatic subdural fluid collection was detected in 12 patients. The treatment of these patients consisted of reprogramming of the valve’s opening pressure. In 5 patients small subdural hematomas were detected; 4 of these patients were treated by raising the opening pressure alone and one patient required surgical drainage and change of the pressure setting. Traumatic chronic subdural hematomas were detected in 6 patients. These patients were treated by surgical drainage and readjustment of the valve’s opening pressure.Conclusion. The ability to treat a shunt-related complication, such as a subdural fluid collection, by reprogramming the valve’s opening pressure to a higher setting is an advantage over nonprogrammable valves, and it enables the opening pressure to be slowly lowered once the fluid collection is reabsorbed. Based on our results, we believe that programmable shunt valves should be preferred.

scholarly journals Infrequent Hemorrhagic Complications Following Surgical Drainage of Chronic Subdural Hematomas

2015 ◽  
Vol 57 (5) ◽  
pp. 379 ◽  
Author(s):  
Angelo Rusconi ◽  
Simone Sangiorgi ◽  
Lidia Bifone ◽  
Sergio Balbi
Keyword(s):  
Surgical Drainage ◽  
Subdural Hematomas ◽  
Hemorrhagic Complications

scholarly journals Epidemiological characteristics of 778 patients who underwent surgical drainage of chronic subdural hematomas in Brasília, Brazil

BMC Surgery ◽  
2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Emerson B Sousa ◽  
Laise FS Brandão ◽  
Cléciton B Tavares ◽  
Igor BC Borges ◽  
Nelson G Freire Neto ◽  
...  
Keyword(s):  
Surgical Drainage ◽  
Subdural Hematomas ◽  
Epidemiological Characteristics

Endovascular Therapy of Carotid Cavernous Fistulas

1994 ◽  
Vol 5 (3) ◽  
pp. 485-495 ◽  
Author(s):  
Stanley L. Barnwell ◽  
Oisin R. O'Neill
Keyword(s):  
Endovascular Therapy ◽  
Carotid Cavernous Fistulas

Chronic subdural hematomas: single versus double burr holes

2020 ◽  
Vol 64 (2) ◽  
Author(s):  
Salvatore D'oria ◽  
Mariagrazia Dibenedetto ◽  
Eleonora Squillante ◽  
Carlo Delvecchio ◽  
Francesco Zizza ◽  
...  
Keyword(s):  
Subdural Hematomas ◽  
Burr Holes ◽  
Single Versus

Management and outcomes of isolated interhemispheric subdural hematomas associated with falx syndrome

2019 ◽  
Vol 131 (6) ◽  
pp. 1920-1925
Author(s):  
Daniel A. Tonetti ◽  
William J. Ares ◽  
David O. Okonkwo ◽  
Paul A. Gardner
Keyword(s):  
Neurological Deterioration ◽  
Neurological Deficits ◽  
Motor Deficits ◽  
Study Cohort ◽  
Venous Infarction ◽  
Nonsurgical Management ◽  
Subdural Hematomas ◽  
Poor Outcomes ◽  
Contemporary Management

OBJECTIVELarge interhemispheric subdural hematomas (iSDHs) causing falx syndrome are rare; therefore, a paucity of data exists regarding the outcomes of contemporary management of iSDH. There is a general consensus among neurosurgeons that large iSDHs with neurological deficits represent a particular treatment challenge with generally poor outcomes. Thus, radiological and clinical outcomes of surgical and nonsurgical management for iSDH bear further study, which is the aim of this report.METHODSA prospectively collected, single-institution trauma database was searched for patients with isolated traumatic iSDH causing falx syndrome in the period from January 2008 to January 2018. Information on demographic and radiological characteristics, serial neurological examinations, clinical and radiological outcomes, and posttreatment complications was collected and tallied. The authors subsequently dichotomized patients by management strategy to evaluate clinical outcome and 30-day survival.RESULTSTwenty-five patients (0.4% of those with intracranial injuries, 0.05% of those with trauma) with iSDH and falx syndrome represented the study cohort. The average age was 73.4 years, and most patients (23 [92%] of 25) were taking anticoagulants or antiplatelet medications. Six patients were managed nonoperatively, and 19 patients underwent craniotomy for iSDH evacuation; of the latter patients, 17 (89.5%) had improvement in or resolution of motor deficits postoperatively. There were no instances of venous infarction, reaccumulation, or infection after evacuation. In total, 9 (36%) of the 25 patients died within 30 days, including 6 (32%) of the 19 who had undergone craniotomy and 3 (50%) of the 6 who had been managed nonoperatively. Patients who died within 30 days were significantly more likely to experience in-hospital neurological deterioration prior to surgery (83% vs 15%, p = 0.0095) and to be comatose prior to surgery (100% vs 23%, p = 0.0031). The median modified Rankin Scale score of surgical patients who survived hospitalization (13 patients) was 1 at a mean follow-up of 22.1 months.CONCLUSIONSiSDHs associated with falx syndrome can be evacuated safely and effectively, and prompt surgical evacuation prior to neurological deterioration can improve outcomes. In this study, craniotomy for iSDH evacuation proved to be a low-risk strategy that was associated with generally good outcomes, though appropriately selected patients may fare well without evacuation.

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